Provider Demographics
NPI:1831181064
Name:CORSARO, MARIA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CORSARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:1198
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-1603
Mailing Address - Fax:718-270-2667
Practice Address - Street 1:1900 HEMPSTEAD TPKE
Practice Address - Street 2:500
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1724
Practice Address - Country:US
Practice Address - Phone:516-542-1090
Practice Address - Fax:516-794-8165
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2121202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01976627Medicaid
NY695931Medicare ID - Type Unspecified
NY01976627Medicaid