Most Relevant Information
Provider Data
NPI Number: | 1003558552 |
Provider Name: | JOSEPHINE LA CORTE |
Entity Type: | Individual |
Taxonomy Code: | 302R00000X |
Specialty: | Health Maintenance Organization |
License Number: |
Most Important Dates
Enumeration Date: | 04/13/2022 |
Last Updated: | 04/13/2022 |
Provider Practice Location
445 OAK ST
COPIAGUE
NY
117263111
Practice Location Phone/Fax
Phone: | 6312575173 |
Fax: |
Provider Mailing Location
16 GARDEN PL
SHIRLEY
NY
119672208
Provider Mailing Phone/Fax
Phone: | 6315766758 |
Fax: |