Individual
THOMAS JOSEPH CORSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
111 BREWSTER ST, MEMORIAL HOSPITAL OF RI /DEPT OF SURGERY, PAWTUCKET, RI 02860-4400
(401) 729-2241
(401) 729-2286
Mailing address
111 BREWSTER ST, WOOD BLDG #516, PAWTUCKET, RI 02860-4400
(401) 729-3481
(401) 729-2721
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00311
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27994-5
RI BLUE CROSS ID NUMBER
RI
01
—
9790062661
MEDICARE PTAN
RI
05
—
TC73054
—
RI
Enumeration date
06/15/2006
Last updated
09/02/2011
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