Provider Demographics
NPI:1013125129
Name:CORRADO, LOUIS JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:JOSEPH
Last Name:CORRADO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6917
Mailing Address - Country:US
Mailing Address - Phone:631-271-1941
Mailing Address - Fax:631-271-1941
Practice Address - Street 1:245 MCKINLEY TER
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1311
Practice Address - Country:US
Practice Address - Phone:631-271-1941
Practice Address - Fax:631-271-1941
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9310103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical