Provider Demographics
NPI:1801483565
Name:CORLEW, DORIS
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:CORLEW
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 1:2917 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-2664
Mailing Address - Country:US
Mailing Address - Phone:216-403-7392
Mailing Address - Fax:
Practice Address - Street 1:2917 GRANT ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-2664
Practice Address - Country:US
Practice Address - Phone:216-403-7392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH999999OtherHOME HEALTH AIDE