Corallo, Diane M

Corallo, Diane M is an individual health care provider with primary practice located at 485 Royer Dr Ste 103 , Lancaster PA 17601-5102. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Corallo, Diane M can be contacted via phone (717) 560-4020.

Contact Information

Primary practice address
485 Royer Dr Ste 103 Lancaster PA 17601-5102
Phone: (717) 560-4020
Fax: (717) 560-2919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD042035E Pennsylvania

Profile Details

NPI number 1619977790
LBN Legal business name Corallo, Diane M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Dec 8th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619977790 NPPES
Pennsylvania MEDICAID 000646989
Pennsylvania MEDICAID 0012571430001
Pennsylvania Other 37812

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