Provider Demographics
NPI:1215035886
Name:CORRIEL, DANA (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CORRIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ENGLE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2507
Mailing Address - Country:US
Mailing Address - Phone:201-567-2050
Mailing Address - Fax:201-568-8936
Practice Address - Street 1:30 MONTGOMERY ST
Practice Address - Street 2:720
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3829
Practice Address - Country:US
Practice Address - Phone:212-524-7730
Practice Address - Fax:212-524-7788
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09399300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine