Cornelissen, Simon M
Cornelissen, Simon M is an individual health care provider with primary practice located at 15 Roche Bros Way , North Easton MA 02356. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Cornelissen, Simon M can be contacted via phone (781) 344-3535.Contact Information
Primary practice address
15 Roche Bros Way
North Easton MA 02356
Phone: (781) 344-3535
Fax: (508) 535-0192
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 208328 | Massachusetts |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 208328 | Massachusetts |
Profile Details
| NPI number | 1699759415 |
|---|---|
| LBN Legal business name | Cornelissen, Simon M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Aug 16th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699759415 | NPPES |
| Massachusetts | MEDICAID | 0143821 |
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