Healthcare Provider Details

I. General information

NPI: 1124027297
Provider Name (Legal Business Name): NORMAN A KORNWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CENTERVILLE RD
WARWICK RI
02886-4336
US

IV. Provider business mailing address

120 CENTERVILLE RD
WARWICK RI
02886-4336
US

V. Phone/Fax

Practice location:
  • Phone: 401-738-3730
  • Fax: 401-738-3777
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberRI6615
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: