Provider Demographics
NPI:1124117130
Name:CORRADI, RICHARD BRYON (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRYON
Last Name:CORRADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 MIDDLEDALE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2524
Mailing Address - Country:US
Mailing Address - Phone:216-291-4423
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVENUE
Practice Address - Street 2:UNIVERSITY HOSPITALS
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-5000
Practice Address - Country:US
Practice Address - Phone:216-844-3417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 0254202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry