Provider Demographics
NPI:1245119114
Name:CORSO, MADISON TAYLOR
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:TAYLOR
Last Name:CORSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MARLIN RD
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-3035
Mailing Address - Country:US
Mailing Address - Phone:631-438-7770
Mailing Address - Fax:
Practice Address - Street 1:39 MARLIN RD
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-3035
Practice Address - Country:US
Practice Address - Phone:631-438-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist