Individual provider · NPI-1
Alexis M Cornelius
Early Intervention Provider Agency · Oswego, NY
NPI number1710568696
StatusActive
Last updated in NPPESApr 21, 2021
Details
- NPI
- 1710568696
- Entity type
- Individual (NPI-1)
- Name
- Alexis M Cornelius
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 21, 2021
- Certification date
- Apr 21, 2021
- Last updated
- Apr 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | – | Yes |
Practice location
159 W 1st StOswego, NY 13126-2045
Phone 315-342-9575
Mailing address
133 E 9th StOswego, NY 13126-1617
Phone 315-236-3059
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