Provider Demographics
NPI:1679883045
Name:DEL CORSO, LAURA (RPH)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:DEL CORSO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HASTINGS RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3024
Mailing Address - Country:US
Mailing Address - Phone:973-455-0648
Mailing Address - Fax:
Practice Address - Street 1:180 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-3052
Practice Address - Country:US
Practice Address - Phone:201-791-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ00898183500000X
NJ28RI01781300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist