Individual
DR. JAMES VINCENT CORNETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000158
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010284716
—
VA
01
—
178555
ANTHEM BCBS
VA
01
—
25072
OPTIMA
VA
Enumeration date
11/04/2005
Last updated
06/30/2009
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