| Doctor Name: | CATHY CORSON-DIAZ |
| NPI Number: | 1609030089 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | MA061653 |
| Business Practice Address: | 380 Egg Harbor Rd Ste C9 Sewell, NJ - 080803152 |
| Business Phone Number: | 8565891151 |
| Business Fax Number: | 8565891554 |
| Mailing Address: | 380 Egg Harbor Rd Ste C9, SEWELL |
| State: | NJ |
| Postal Code: | 080803152 |
| Phone Number: | 8565891151 |
| Fax Number: | 8565891554 |
| NPI Enumeration Date: | 07/15/2008 |
| NPI Last Update Date: | 07/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MA061653 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |