Anthony Albert Corrao, D.D.S.
Individual provider Active NPI General Practice Dentistry · Old Lyme, CT
NPI 1124231279 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124231279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4249 (CT)
- Practice address
- 6 Davis Rd W
Old Lyme, CT 06371-1448 - Phone
- (860) 434-5565
- Fax
- (860) 434-5880
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4249 | CT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4249 | CT | Yes |
Addresses
Primary practice location
6 Davis Rd W
Old Lyme, CT 06371-1448
Mailing address
74 Ayers Point Rd
Old Saybrook, CT 06475-4301
Phone (860) 388-4383
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4249 | Other | CT | STATE LICENSE |
Other providers in Old Lyme, CT
- Circulatory Centers Connecticut, LLC
- Nicole Sun Cirilli
- Karen Ann Claise
- Elizabeth Jane Clark
- William Clinton
- Mary Cummings Satti
- Suresh Cec Il D'Mello
- Michael Anthony D'Occhio
- Robert Dean
- Michelle Kathryn Deyorio
All providers in Old Lyme, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.