Individual
DR. JAMES S CORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
(201) 796-2255
(201) 796-3711
Mailing address
31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
(201) 796-2255
(201) 796-3711
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25MA06342700
NJ
207RP1001X
Pulmonary Disease Physician
Primary
25MA05633300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01363491
NEW YORK MEDICAID ID
NY
05
—
6225802
—
NJ
Enumeration date
01/03/2007
Last updated
01/18/2011
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