Cornell, Russell John
Cornell, Russell John is an individual health care provider with primary practice located at 368 Lakehurst Rd Ste 301, Toms River NJ 08755-7339. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Cornell, Russell John can be contacted via phone (732) 240-1048.Contact Information
Primary practice address
368 Lakehurst Rd Ste 301
Toms River NJ 08755-7339
Phone: (732) 240-1048
Fax: (732) 240-3464
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 25MA03223600 | New Jersey |
Profile Details
| NPI number | 1285639088 |
|---|---|
| LBN Legal business name | Cornell, Russell John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Apr 4th, 2012 - about 12 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 | 1285639088 | NPPES |
| New Jersey | MEDICAID | 1645901 |
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