Provider Demographics
NPI:1295317428
Name:BORDIERI, CORINNE MARIE (OT)
Entity type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:MARIE
Last Name:BORDIERI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:CORINNE
Other - Middle Name:MARIE
Other - Last Name:ABBATEMARCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:456 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-3512
Mailing Address - Country:US
Mailing Address - Phone:201-887-7653
Mailing Address - Fax:
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4823
Practice Address - Country:US
Practice Address - Phone:212-606-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1832104225X00000X
NJ46TR00500000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist