Organization
CORNELL ORTHOTICS AND PROSTHETICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH DONALD CORNELL C.P. (PRESIDENT)
(978) 922-2866
Entity
Organization
Contact information
Practice address
100 CUMMINGS CTR, SUITE 207H, BEVERLY, MA 01915-6115
(978) 922-2866
(978) 922-0277
Mailing address
100 CUMMINGS CTR, SUITE 207H, BEVERLY, MA 01915-6115
(978) 922-2866
(978) 922-0277
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527975
—
MA
01
—
355654
BCBS
MA
01
—
700854
HARVARD
MA
01
—
801259
TUFTS MEDICARE PREFERRED
MA
01
—
8853
NEIGHBORHOOD HEALTH PLAN
MA
Enumeration date
08/15/2005
Last updated
01/30/2023
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