Individual
PATRICK CORRELLI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0004155
MD
Other
Enumeration date
01/21/2010
Last updated
03/31/2010
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