Mary Lou Corcoran PT, P.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

006344-1 Issued in NY

Legal business name

MARY LOU CORCORAN PT, P.C.

Practice address

6711 Towpath Rd Ste 100
East Syracuse, NY 13057-9509

Phone

(315) 637-4747

Fax

(315) 637-6711

NPI assigned

Jul 30, 2006

Organization subpart

No

Name

Mary Lou Corcoran, PTNPI 1750327763

Title

President

Phone

(315) 637-4747

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Lou Corcoran, PT

  • Physical Therapist
  • Fayetteville, NY
  • NPI 1750327763

  NY

  Medicare reassignment NPD Authorized official
• Jill A Spinoso, PT

  • Physical Therapist
  • De Witt, NY
  • NPI 1326339599

  NY

  Medicare reassignment Care Compare group NPD
• Robert George Wolfe III, PT

  • Physical Therapist
  • Fayetteville, NY
  • NPI 1760421325

  NY

  Medicare reassignment Care Compare group NPD
• Brian J Dube

  • Physical Therapist
  • Salinas, CA
  • NPI 1275173981

  NY

  Medicare reassignment Care Compare group NPD
• Troy S Andrews, PT

  • Physical Therapist
  • East Syracuse, NY
  • NPI 1902837347

  NY

  Medicare reassignment NPD
• Meghan Barry, PT

  • Physical Therapist
  • Syracuse, NY
  • NPI 1447730270

  NY

  Medicare reassignment NPD
• Elizabeth Kulik, DPT

  • Physical Therapist
  • Syracuse, NY
  • NPI 1184032468

  NY

  Medicare reassignment NPD
• Katherine Mary Lyons, PTA

  • Physical Therapist
  • East Syracuse, NY
  • NPI 1003514977
  NPD
• Larry Michael Gravante, PT

  • Physical Therapist
  • Fayetteville, NY
  • NPI 1801825377
  NPD (past)
• Elizabeth M Kiggins, PT

  • Physical Therapist
  • East Syracuse, NY
  • NPI 1780615120
  NPD (past)
• Jessica Amanda Knapp, PT

  • Physical Therapist
  • Fayetteville, NY
  • NPI 1649446170
  NPD (past)
• Jessica Anne Knox, PT

  • Physical Therapist
  • Syracuse, NY
  • NPI 1417075938
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 1, 2020.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1699780338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6711 TOWPATH RD STE 100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579509",
            "telephone_number": "315-637-4747",
            "fax_number": "315-637-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6711 TOWPATH RD STE 100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579509",
            "telephone_number": "315-637-4747",
            "fax_number": "315-637-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY LOU CORCORAN PT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "CORCORAN",
        "authorized_official_first_name": "MARY LOU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-637-4747",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "006344-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AU96",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Marotta, MD
• Caryn Suzanne Marr, OTR/L
• Vanessa Anne Martinez
• Marie Christina Martini, LMT
• Mary L Oot, FNP, P.C.
• Tracy Massa, MD
• Thomas D Masten, MD
• Ashley Masterpol
• Jennifer L Mastropietro, NP
• Subinse Mathew

• All providers in East Syracuse, NY
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.