Cornelio, Jason M.

Cornelio, Jason M. is an individual health care provider with primary practice located at 711 Cottage Grove Rd , Bloomfield CT 06002-3060. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Cornelio, Jason M. can be contacted via phone (860) 242-8756.

Contact Information

Primary practice address
711 Cottage Grove Rd Bloomfield CT 06002-3060
Fax: (860) 242-3052
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3334 Connecticut

Profile Details

NPI number 1730569740
LBN Legal business name Cornelio, Jason M.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2015
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730569740 NPPES
Connecticut MEDICAID 1730569740
Connecticut Other D400225889

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