Provider Demographics
NPI:1386906121
Name:AMATULLI, CORINE RINO (MSED)
Entity type:Individual
Prefix:MS
First Name:CORINE
Middle Name:RINO
Last Name:AMATULLI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 JACOB ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2232
Mailing Address - Country:US
Mailing Address - Phone:516-353-8319
Mailing Address - Fax:
Practice Address - Street 1:280 JACOB ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2232
Practice Address - Country:US
Practice Address - Phone:516-353-8319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator