Individual
AUBREY ELAINE CORNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3000
Mailing address
4459 DRIFTWOOD DR, PHILADELPHIA, PA 19129-1783
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
023088
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/31/2018
Last updated
12/12/2018
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