Individual
CORNELIA VANDERZIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4302
(617) 661-5585
(617) 661-5107
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
52836
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014780
NEIGHBORHOOD HEALTH PLAN
MA
01
—
0233445-002
CIGNA HEALTH CARE
MA
01
—
052836
TUFTS HEALTH PLAN
MA
05
—
3179931
—
MA
01
—
G179
HARVARD PILGRIM
MA
01
—
J03754
BCBS MA
MA
Enumeration date
12/19/2006
Last updated
08/16/2011
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