Healthcare Provider Details

I. General information

NPI: 1730235292
Provider Name (Legal Business Name): CAROL C CORNFELDT APN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COMMUNITY PLACE FOURTH FLOOR
MORRISTOWN NJ
07960
US

IV. Provider business mailing address

20 COMMUNITY PLACE FOURTH FLOOR
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 973-292-1890
  • Fax: 973-539-3687
Mailing address:
  • Phone: 973-292-1890
  • Fax: 973-539-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number26NC03405800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: