EDWARD C. CORSELLO D.C. L.L.C (NPI# 1922296110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922296110 |
| Entity Type | Organization |
| Organization Name | EDWARD C. CORSELLO D.C. L.L.C |
| Practice Address |
3333 Main St Stratford CT 06614-4861 |
| Practice Telephone | 2033811800 |
| Practice Fax Number | 2033811801 |
| Mailing Telephone | 2033811800 |
| Mailing Fax Number | 2033811801 |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2007-11-06 |
| Authorized Official Name | DR. EDWARD CORSELLO (OWNER/DOCTOR) |
| Authorized Official Telephone | 2033811800 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NI0900X |
Chiropractor Specialization: Internist |
001562 | CT | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM PROVIDER ID | 050001562CT04 | 01 |
| CT | HEALTHNET PROVIDER ID | CV9313 | 01 |
| CT | CT CARE PAYER ID | 06105 | 01 |
| CT | OXFORD ID | P3570853 | 01 |
| Street Address |
3333 MAIN ST |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-4861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649337452 | Edward Corsello | Chiropractor | 3333 Main St, Stratford, CT 06614-4861 | 2007-01-02 |
| 1033248349 | Drusilla Demarest Cherry | Social Worker | 3333 Main St, Stratford, CT 06614-4861 | 2007-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588139604 | David A Crosby | Physician Assistant | 125 Pumpkin Ground Road, Stratford, CT 06614 | 2018-10-04 |
| 1710489232 | Karen Marie Laconte | Naturopath | 720 Hilltop Dr, Stratford, CT 06614 | 2018-02-28 |
| 1972024693 | Amanda Wilson | Social Worker | 60 Edmund Street, Stratford, CT 06614 | 2017-07-03 |
| 1558801423 | Kristine Lynn Conlan | Physical Therapist | 55 Pasadena Ave., Stratford, CT 06614 | 2017-02-27 |
| 1811440258 | Seokwon Kwon | Dentist | 320 Boston Ave, Stratford, CT 06614 | 2016-08-02 |
| 1093176141 | Kathleen G Domek | Technician/Technologist | 150 Barnum Avenue Cut Off, Stratford, CT 06614 | 2016-03-17 |
| 1417328634 | Kelley Machado | Social Worker | 2127 Nichols Ave, Stratford, CT 06614 | 2015-10-14 |
| 1043629553 | Jennifer Woods-mesquita | Social Worker | 125 Greenlawn Ave, Stratford, CT 06614 | 2014-08-08 |
| 1437564010 | Jose R. Pacheco | Obstetrics & Gynecology | 120 Brightwood Ave, Stratford, CT 06614 | 2014-06-23 |
| 1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
| Find all providers in zip 06614 | ||||
| Taxonomy Code | 111NI0900X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Internist |
| The chiropractic internist may serve as a primary care physician or may see patients referred from other providers for evaluation and co-management. Evaluation is focused on the early detection of functional, nutritional, and pathological disorders. A chiropractic internist utilizes the diagnostic instruments necessary for proper examination. In cases where laboratory examination is necessary, a chiropractic internist utilizes a recognized reference laboratory facility. A chiropractic internist may manage his or her own cases or may refer to another specialist when prudent to do so. The chiropractic internist utilizes documented natural therapies, therapeutic lifestyle changes, patient education and other resources to promote patient health and avoidance of disease. |
| Notes: Source: American Chiropractic Association, 2008 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649337452 | Edward Corsello | Chiropractor | 3333 Main St, Stratford, CT 06614-4861 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992087209 | Kevin Keith Bodling | Chiropractor | 1 Titus Rd, Suite 2, Washington Depot, CT 06794-1516 | 2011-09-13 |
| 1811289085 | David Wickes | Chiropractor | 453 Fisher Ct, Shelton, CT 06484-2836 | 2011-05-06 |
| 1609172832 | Michael James Distler | Chiropractor | 34 Wagon Wheel Rd, Redding, CT 06896-1619 | 2011-02-05 |
| 1598892069 | Thomas Dale Worden | Chiropractor | 41 Kenosia Ave Ste 101, Danbury, CT 06810-7360 | 2007-02-28 |
| 1215958772 | Back To Health of Branford, LLC | Chiropractor | 400 West Main Street, Branford, CT 06405 | 2006-07-21 |
| 1740687441 | Doctors Choice Professional Laboratory & Diagnostic Services, Inc. | Chiropractor | 1 Titus Rd, Washington Depot, CT 06794-1516 | 2014-11-24 |
| 1285806893 | Carpenos Chiropractic Center | Chiropractor | 666 Campbell Ave, West Haven, CT 06516-3775 | 2008-03-24 |
| 1053401901 | Colleen Pace | Chiropractor | 3154 Whitney Ave, Hamden, CT 06518-2321 | 2006-10-13 |
| 1558381715 | Joseph M Gambino | Chiropractor | 526 Newfield Ave, Stamford, CT 06905 | 2006-07-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.