Provider Demographics
NPI:1720594229
Name:FILLMAN, CORRINE (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:CORRINE
Middle Name:
Last Name:FILLMAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2606
Mailing Address - Country:US
Mailing Address - Phone:610-628-7039
Mailing Address - Fax:201-605-6582
Practice Address - Street 1:240 CETRONIA RD STE 225S
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9701
Practice Address - Country:US
Practice Address - Phone:484-503-4160
Practice Address - Fax:833-616-6610
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000205170300000X
NJ25MJ00017700170300000X
IL246.000236170300000X
CAGC000677170300000X
PAGC000101170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS