Organization
EDWARD C. CORSELLO D.C. L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD CORSELLO D.C. (OWNER/DOCTOR)
(203) 381-1800
Entity
Organization
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
001562
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001562CT04
ANTHEM PROVIDER ID
CT
01
—
06105
CT CARE PAYER ID
CT
01
—
CV9313
HEALTHNET PROVIDER ID
CT
01
—
P3570853
OXFORD ID
CT
Enumeration date
10/12/2007
Last updated
11/06/2007
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