Provider Demographics
NPI:1528215027
Name:CORSETTI, MEGAN (PT)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:CORSETTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CENTER GROVE RD
Mailing Address - Street 2:APARTMENT T47
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-4450
Mailing Address - Country:US
Mailing Address - Phone:570-977-1381
Mailing Address - Fax:
Practice Address - Street 1:600 S LIVINGSTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5419
Practice Address - Country:US
Practice Address - Phone:800-530-3247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA0127500171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor