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General NPI Number Information
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NPI Number | 1164467924
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Entity Type | Individual
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Provider Name | CAROL L KORNMEHL M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 2090 SPRINGDALE RD STE B
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2024
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Country | US
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Telephone | 856-751-9010
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 SPRINGDALE RD STE B
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2024
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Country | US
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Telephone | 856-751-9010
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 25MA05055500
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License Number State | NJ
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