Provider Demographics
NPI:1801150107
Name:CORRIE, CATHY JOAN (MS EDU)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:JOAN
Last Name:CORRIE
Suffix:
Gender:F
Credentials:MS EDU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ROYALSTON LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11720-1414
Mailing Address - Country:US
Mailing Address - Phone:631-696-1509
Mailing Address - Fax:631-698-4075
Practice Address - Street 1:33 ROYALSTON LN
Practice Address - Street 2:
Practice Address - City:SOUTH SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11720-1414
Practice Address - Country:US
Practice Address - Phone:631-696-1509
Practice Address - Fax:631-698-4075
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist