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Individual

JOSEPHINE LA CORTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
445 OAK ST, COPIAGUE, NY 11726-3111
(631) 257-5173
Mailing address
16 GARDEN PL, SHIRLEY, NY 11967-2208
(631) 576-6758

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
NY

Other

Enumeration date
04/13/2022
Last updated
04/13/2022
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