Individual
CORNELIUS T TYRRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF PEDIATRICS, WORCESTER, MA 01655-0002
(508) 334-7986
(508) 334-7989
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
237352
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110084107A
—
MA
Enumeration date
01/30/2007
Last updated
10/27/2020
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