Provider Demographics
NPI:1568701399
Name:CORCORAN, ROBERT M (DPT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:CORCORAN
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:333 EARLE OVINGTON BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3610
Mailing Address - Country:US
Mailing Address - Phone:516-321-2424
Mailing Address - Fax:516-321-2424
Practice Address - Street 1:2048 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3521
Practice Address - Country:US
Practice Address - Phone:718-252-0300
Practice Address - Fax:718-252-3619
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2016-10-31
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Provider Licenses
StateLicense IDTaxonomies
NY035681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4WFH1Medicare PIN