Most Relevant Information
Provider Data
| NPI Number: | 1003450479 |
| Provider Name: | NICOLE MARIE CORVAIA ATR. LCAT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/29/2019 |
| Last Updated: | 10/29/2019 |
Provider Practice Location
161 E MAIN ST
SMITHTOWN
NY
117872879
Practice Location Phone/Fax
| Phone: | 6313607578 |
| Fax: |
Provider Mailing Location
161 E MAIN ST
SMITHTOWN
NY
117872879
Provider Mailing Phone/Fax
| Phone: | 6313607578 |
| Fax: |