David Corallo (NPI# 1225126212, PAC ID# 4880739150) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1225126212 |
| PAC ID by PECOS | 4880739150 |
| Professional Enrollment ID | I20100311000343 |
| Full Name | David Corallo |
| Organization Legal Name | DAVID J. CORALLO, D.O. |
| Address |
18586 W 5th St Beloit OH 44609-9799 |
| Phone Number | 3309383333 |
| Gender | M |
| Medical School | NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY |
| Graduation Year | 1995 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 1153466438 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360064 | ST ELIZABETH YOUNGSTOWN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 18586 W 5th St, Beloit, OH 44609-9799 | 3309383333 | DAVID J. CORALLO, D.O. |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | DAVID J. CORALLO, D.O. |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicole Darty | Physician Assistant | David J. Corallo, D.o. | 18586 W 5th St, Beloit, OH 44609-9799 |
| Street Address |
18586 W 5TH ST |
| City | BELOIT |
| State | OH |
| Zip | 44609-9799 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicole Darty | Physician Assistant | David J. Corallo, D.o. | 18586 W 5th St, Beloit, OH 44609-9799 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marco Rosario Corallo | Endocrinology | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| Brook A Gram | Physician Assistant | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| Krista Rubosky | Physician Assistant | Marco R Corallo Do LLC | 18586 5th St, Beloit, OH 44609-9799 |
| City | BELOIT |
| Zip Code | 44609 |
| Specialty | DERMATOLOGY |
| City + Specialty | BELOIT + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.