Provider Demographics
NPI:1881118115
Name:CORRADO, MATTHEW JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JAMES
Last Name:CORRADO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 NASSAU BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY S
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5313
Mailing Address - Country:US
Mailing Address - Phone:516-292-7948
Mailing Address - Fax:516-292-5154
Practice Address - Street 1:317 NASSAU BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY S
Practice Address - State:NY
Practice Address - Zip Code:11530-5313
Practice Address - Country:US
Practice Address - Phone:516-292-7948
Practice Address - Fax:516-292-5154
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist