Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 149220 | NY |
N | 207X00000X | Orthopaedic Surgeon | 39238 | CT |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 039238 | CT |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 149220 | NY |
NPI | 1316033426 |
---|---|
Provider Name | Charles N. Cornell |
First Address | New York, NY 10087-9234 |
Second Address | New York, NY 10021-4872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 18/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01799820 | (05) | NY |
A64250 | (02) | NY |