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Individual

CRISTOBAL CORNEJO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
360 HUNTINGTON AVE, 135 FORSYTH BUILDING, BOSTON, MA 02115-5005
(617) 373-8933
(617) 373-2601
Mailing address
7 TRISTAN CT, WORCESTER, MA 01602-1314
(774) 261-0323

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
653
MA

Other

Enumeration date
03/29/2006
Last updated
07/08/2007
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