Individual
JENNIFER FOSTER CORNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-1957
(215) 456-8502
Mailing address
PO BOX 13918, PHILADELPHIA, PA 19101-3918
(215) 456-7000
(215) 254-3289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053615
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232664784
TAD ID
PA
Enumeration date
11/11/2008
Last updated
02/25/2013
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