Provider Demographics
NPI:1699882472
Name:CORSI, AMY NM (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NM
Last Name:CORSI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1500 OAKLAWN AVE
Mailing Address - Street 2:AUDREY GALLI PHYSICAL THERAPY INC
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-2656
Mailing Address - Country:US
Mailing Address - Phone:401-463-0113
Mailing Address - Fax:401-463-5808
Practice Address - Street 1:1500 OAKLAWN AVE
Practice Address - Street 2:AUDREY GALLI PHYSICAL THERAPY INC
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-463-0113
Practice Address - Fax:401-463-5808
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01514225100000X
MA13229225100000X
CT006442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI312927OtherBLUE CROSS
RI406427OtherBLUE CHIP