Individual
THOMAS JOSEPH CORSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
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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