Individual
DR. CORINNE BROOKE VIDULICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
271 ROUTE 25A STE 2, WADING RIVER, NY 11792-2014
(631) 727-4950
Mailing address
37 FRONT ST APT 5, GREENPORT, NY 11944-1639
(917) 655-1312
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
301007-01
NY
Other
Enumeration date
04/01/2016
Last updated
04/17/2025
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