Provider Demographics
NPI:1770049876
Name:CORROS, APRIL JANE GUMATAS
Entity type:Individual
Prefix:
First Name:APRIL JANE
Middle Name:GUMATAS
Last Name:CORROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11637 MAID AT ARMS LN
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1638
Mailing Address - Country:US
Mailing Address - Phone:206-304-1348
Mailing Address - Fax:
Practice Address - Street 1:37155 REHOBOTH AVENUE EXT
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-3194
Practice Address - Country:US
Practice Address - Phone:302-227-2008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-00034372251G0304X, 225100000X
MD258472251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics