Provider Demographics
NPI:1851371801
Name:CIPRIASO, CORAZON (MD)
Entity Type:Individual
Prefix:DR
First Name:CORAZON
Middle Name:
Last Name:CIPRIASO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-0790
Mailing Address - Country:US
Mailing Address - Phone:732-492-8241
Mailing Address - Fax:888-685-8722
Practice Address - Street 1:1 TANGLEWOOD PL E
Practice Address - Street 2:
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-3268
Practice Address - Country:US
Practice Address - Phone:908-601-5296
Practice Address - Fax:866-506-2790
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07358200225400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ055477Medicare PIN
NJH56092Medicare UPIN