Individual
MARY CORSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN,CDN
Contact information
Practice address
428 ROUTE 25A, MILLER PLACE, NY 11764-2514
(631) 509-5544
Mailing address
283 CENACLE RD, LAKE RONKONKOMA, NY 11779-2201
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
010966-01
NY
133V00000X
Registered Dietitian
1884029
NY
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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