Provider Demographics
NPI:1174978258
Name:SCARPA, CORINNE (MS, MED, ATC EMT-B)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:SCARPA
Suffix:
Gender:F
Credentials:MS, MED, ATC EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3525
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:272 BERDAN AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3240
Practice Address - Country:US
Practice Address - Phone:973-314-2009
Practice Address - Fax:973-633-3114
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001519002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer