Provider Demographics
NPI:1982971230
Name:CORRIVEAU, DENISE T (MS, PT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:T
Last Name:CORRIVEAU
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-3302
Mailing Address - Country:US
Mailing Address - Phone:914-741-5474
Mailing Address - Fax:
Practice Address - Street 1:82 BIRCH DR
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-3302
Practice Address - Country:US
Practice Address - Phone:914-741-5474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008573174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist