Provider Demographics
NPI:1104053636
Name:CROCE, CORINNE G (DPT)
Entity type:Individual
Prefix:MISS
First Name:CORINNE
Middle Name:G
Last Name:CROCE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BOND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2495
Mailing Address - Country:US
Mailing Address - Phone:516-637-2367
Mailing Address - Fax:
Practice Address - Street 1:33 BOND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2495
Practice Address - Country:US
Practice Address - Phone:516-637-2367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030985-1225100000X
NY030985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist