Provider Demographics
NPI:1114363918
Name:CORSELLO, GUY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:ROBERT
Last Name:CORSELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3308
Mailing Address - Country:US
Mailing Address - Phone:412-831-1673
Mailing Address - Fax:
Practice Address - Street 1:2342 GOLFVIEW DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3308
Practice Address - Country:US
Practice Address - Phone:412-831-1673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010334E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology