Tanner D Corse, MD
Student in an Organized Health Care Education/Training Program in Ridgewood, New Jersey
1619617909- Practice location
- 223 N Van Dien Ave Fl 1, Ridgewood, NJ 07450-2726
- Phone
- 201-689-3900
- Fax
- 551-815-1050
- Last updated
- June 15, 2026
Tanner Donovan Corse is a Student in an Organized Health Care Education/Training Program based in Ridgewood, NJ. Tanner Donovan Corse practices in Ridgewood, NJ and has the professional credentials of MD. The NPI Number for Tanner Donovan Corse is 1619617909 and holds a License No. 25MA13097900 (NJ). The current practice location address for Tanner Donovan Corse is 223 N Van Dien Ave Fl 1, Ridgewood, NJ 07450-2726 and can be reached out via phone at 201-689-3900 and via fax at 551-815-1050.
Provider Profile Details
- NPI Number
- 1619617909
- Provider Name
- Tanner Donovan Corse
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 223 N Van Dien Ave Fl 1, Ridgewood, NJ 07450-2726
- Phone Number
- 201-689-3900
- Fax Number
- 551-815-1050
- Primary Taxonomy
- Student in an Organized Health Care Education/Training Program · 390200000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 1, 2022
- Last Update Date
- June 15, 2026
- Certification Date
- June 15, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 223 N Van Dien Ave Fl 1
Ridgewood, NJ 07450-2726 - City
- Ridgewood
- State
- New Jersey
- Zip
- 07450-2726
- Phone Number
- 201-689-3900
- Fax Number
- 551-815-1050
Provider Business Mailing Address Details
- Address
- 223 N Van Dien Ave Fl 1
Ridgewood, NJ 07450-2726 - City
- Ridgewood
- State
- NJ
- Zip
- 07450-2726
- Phone Number
- 201-689-3900
- Fax Number
- 551-815-1050
License Information
- Taxonomy (1)
- Student in an Organized Health Care Education/Training Program · 390200000X · Primary
- License Number (2)
- 25MA13097900
- License State (2)
- NJ
- Taxonomy (2)
- Internal Medicine · 207R00000X
- License Number (3)
- 25MA13097900
- License State (3)
- NJ
- Taxonomy (3)
- Pediatrics · 208000000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Tanner D Corse, MD?
The NPI number of Tanner D Corse, MD is 1619617909. It was assigned on April 1, 2022 and is currently active in the NPPES registry.
What is the specialty of Tanner D Corse, MD?
Tanner D Corse, MD is registered under the primary taxonomy Student in an Organized Health Care Education/Training Program (code 390200000X), licensed in NJ under license number 25MA13097900.
Where does Tanner D Corse, MD practice?
The practice location is 223 N Van Dien Ave Fl 1, Ridgewood, NJ 07450-2726. The office can be reached at 201-689-3900 (phone) or 551-815-1050 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1619617909 directly on the NPPES registry website.