Individual
DR. EDWARD CORSELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
3333 MAIN ST, STRATFORD, CT 06614-4861
(203) 381-1800
(203) 381-1801
Mailing address
3333 MAIN ST, STRATFORD, CT 06614-4861
(203) 381-1800
(203) 381-1801
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
CT1562
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001562CT04
ANTHEM ID
CT
Enumeration date
01/02/2007
Last updated
07/08/2007
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