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General NPI Number Information
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NPI Number | 1104842046
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Entity Type | Individual
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Provider Name | MR. ROBERT WILLIAM CORNELL
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 95 FALL ST
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City | SENECA FALLS
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State | NY
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Zip | 13148-1408
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Country | US
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Telephone | 315-568-1700
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Fax | 315-568-1300
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Provider Business Mailing Address
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Address Line | 4974 STATE ROUTE 89
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City | ROMULUS
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State | NY
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Zip | 14541-9779
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Country | US
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Telephone | 315-549-8790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 029394
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License Number State | NY
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