Doctor Name: | NIXON CORNAY |
NPI Number: | 1164835211 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | F401696 |
Business Practice Address: | 100 Leisure Ln #9 Stoneham, MA - 021804002 |
Business Phone Number: | 9175871341 |
Business Fax Number: | |
Mailing Address: | 100 Leisure Ln, #9 STONEHAM |
State: | MA |
Postal Code: | 021804002 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/06/2014 |
NPI Last Update Date: | 06/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | F401696 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |