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NPI Code Detail

MEDICARE: ROBERT K CORNUELLE MA

MEDICARE: ROBERT K CORNUELLE MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistA 00730OH
2237600000XAudiologist-Hearing Aid FitterA 00730OH

General Provider Information

NPI Number : 1912969593
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT K CORNUELLE MA
Provider Business Mailing Address
First Line : 1858 SOLUTIONS CTR
Second Line :
City : CHICAGO
State : IL
Zip : 60677-1008
Country : US
Telephone Number : 513-221-0527
Fax Number : 513-221-1703
Provider Business Practice Location Address
First Line : 2825 BURNET AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-2426
Country : US
Telephone Number : 513-221-0527
Fax Number : 513-221-1703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 08/29/2011

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