Provider Demographics
NPI:1518034768
Name:CORRENTE, JAMES R (DPT, PT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:CORRENTE
Suffix:
Gender:M
Credentials:DPT, PT, ATC
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Mailing Address - Street 1:23 LYNNBROOK RD
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-1517
Mailing Address - Country:US
Mailing Address - Phone:781-420-9569
Mailing Address - Fax:781-229-8374
Practice Address - Street 1:100 CUMMINGS CTR, STE 121Q
Practice Address - Street 2:C/O ORTHOPAEDICS PLUS
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6129
Practice Address - Country:US
Practice Address - Phone:978-927-0907
Practice Address - Fax:978-927-0537
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2012-10-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA15053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA470205OtherTUFTS HEALTH PLAN
MA616931OtherHARVARD PILGRIM HEALTH
MA0403087537OtherPRIVATE
MAY68032OtherBLUE CROSS BLUE SHIELD
MA616931OtherHARVARD PILGRIM HEALTH