Active NPI
Corinne M. Waters
- Specialist
- Islip, NY
National Provider Identifier
1770723801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 7683
- Practice address
- 252 Islip Ave
Islip, NY 11751-3029 - Phone
- (631) 581-6800
- Fax
- (631) 581-6814
- NPI assigned
- Mar 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 7683 | NY | Primary |
Addresses
Primary practice location
252 Islip Ave
Islip, NY 11751-3029
Mailing address
101 Sylvan Ave Apt 25
Miller Place, NY 11764-2400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7683 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids in Action | Past | Accepting new patients | |
| Kids in Action of L.I. Inc. | Specialist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Islip, NY
- NPI 1790143311
-
- Specialist
- Islip, NY
- NPI 1366596579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1770723801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SYLVAN AVE APT 25",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117642400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 ISLIP AVE",
"city": "ISLIP",
"state": "NY",
"postal_code": "117513029",
"telephone_number": "631-581-6800",
"fax_number": "631-581-6814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "CORINNE",
"middle_name": "M.",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-02",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "7683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.