Corelife Valley, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CORELIFE VALLEY, LLC

Doing business as

CoreLife

Practice address

3601 Chichester Ave Unit 101
Upper Chichester, PA 19061-3149

Phone

(484) 768-6762

Fax

(855) 772-4748

NPI assigned

Oct 23, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Raymond Joseph Kostkowski

Title

Ceo

Phone

(410) 991-0044

Specialties & licenses 2

Addresses

Other names 1

• CoreLife Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1326681214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD STE 250",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083005",
            "telephone_number": "800-905-3261",
            "fax_number": "855-772-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 CHICHESTER AVE UNIT 101",
            "city": "UPPER CHICHESTER",
            "state": "PA",
            "postal_code": "190613149",
            "telephone_number": "484-768-6762",
            "fax_number": "855-772-4748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "479 Thomas Jones Way Ste 800",
            "address_purpose": "LOCATION",
            "city": "Exton",
            "state": "PA",
            "postal_code": "193412575",
            "country_code": "US",
            "telephone_number": "484-874-2551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2326 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Colmar",
            "state": "PA",
            "postal_code": "18915",
            "country_code": "US",
            "telephone_number": "215-918-8470",
            "fax_number": "215-918-8477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORELIFE VALLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-23",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "KOSTKOWSKI",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-991-0044",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CoreLife",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CoreLife",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terrance Jerome Clarke, MT
• Felicia Clausen, LPN
• Reginald Combs Harris, MSW, LCSW
• Communities of Don Guanella and Divine Providence
• Alexis Conte
• Patricia Costello, MS, RDN, LDN
• Diane Marie Coughlan, CRNP
• Susan D'Alessandris, OTR/L
• Kadiatou Dabo
• Joanne Damico, RPH

• Family Medicine Physician in Upper Chichester, PA
• Providers in Upper Chichester, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.