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General NPI Number Information
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NPI Number | 1427436294
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Entity Type | Individual
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Provider Name | JUSTINE CORMIER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 15 YORK ST YNHH DEPT. NEUROLOGY
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City | NEW HAVEN
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State | CT
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Zip | 06520-8018
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Country | US
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Telephone | 203-785-4085
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Fax |
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Provider Business Mailing Address
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Address Line | 15 YORK ST YNHH DEPT. NEUROLOGY
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City | NEW HAVEN
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State | CT
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Zip | 06520-8018
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Country | US
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Telephone | 203-785-4085
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LP03294
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 64155
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License Number State | CT
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