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General NPI Number Information
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NPI Number | 1811855943
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Entity Type | Individual
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Provider Name | SIMONE CORNELIUS NP
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Gender | Female
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 24 CHERRY ST
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2615
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Country | US
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Telephone | 607-723-8313
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Fax | 607-724-1478
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Provider Business Mailing Address
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Address Line | 23 S MORNINGSIDE DR
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City | BINGHAMTON
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State | NY
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Zip | 13905-1335
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Country | US
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Telephone | 607-759-7088
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 870166
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 870166
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License Number State | NY
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