Provider Demographics
NPI:1124696281
Name:CORCORAN, JOSEPH PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:CORCORAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:PATRICK
Other - Last Name:CORCORAN
Other - Suffix:IV
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:101 NICOLLS RD, HEALTH SCIENCES CAMPUS, L-4, ROOM 050
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-2143
Practice Address - Country:US
Practice Address - Phone:631-689-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT222772207P00000X
NY329518-01207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine