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Individual

MS. CORNELIA VANDERVLIET

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA,CCC-A

Contact information

Practice address
140 BERGEN ST, LEVEL E ROOM 1700, NEWARK, NJ 07103
(973) 972-9500
(973) 972-3923
Mailing address
8 CHANDA CT, CLIFTON, NJ 07012-1936
(973) 365-0381

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
41YA00004900
NJ
237700000X
Hearing Instrument Specialist
25MG00045400
NJ

Other

Enumeration date
04/27/2007
Last updated
12/06/2007
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