CRISTOBAL CORNEJO JR. (NPI# 1659332799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659332799 |
| Entity Type | Individual |
| Full Name | CRISTOBAL CORNEJO JR. |
| Credential | PA-C |
| Practice Address |
360 Huntington Ave 135 Forsyth Building Boston MA 02115-5005 |
| Mailing Address |
7 Tristan Ct Worcester MA 01602-1314 |
| Practice Telephone | 6173738933 |
| Practice Fax Number | 6173732601 |
| Mailing Telephone | 7742610323 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
653 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
360 HUNTINGTON AVE 135 FORSYTH BUILDING |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132078 | Olivia Wilkins | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, 202 Robinson Hall Physician Assistant Program, Boston, MA 02115 | 2020-10-22 |
| 1295333789 | Christine Rose Gencorelli | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5000 | 2020-10-15 |
| 1346848025 | Sydney Elizabeth Donley | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5000 | 2020-10-14 |
| 1023616307 | Manuel Rivera | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5000 | 2020-10-09 |
| 1881292126 | Ashley Mulryan | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5005 | 2020-10-09 |
| 1154928232 | Tereza Pinkhasova | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5000 | 2020-10-02 |
| 1417564832 | Hannah Chmura | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5005 | 2020-09-29 |
| 1740897354 | Makayla Lorch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5005 | 2020-09-28 |
| 1740897396 | Michael Molta II | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5000 | 2020-09-28 |
| 1760099378 | Grady Goldberg | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, Boston, MA 02115-5000 | 2020-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720608912 | John Eastman | Physician Assistant | 243b Savin Hill Ave, Boston, MA 02125-1003 | 2020-04-17 |
| 1366006330 | Theresa Fukuda | Physician Assistant | 43 Bowdoin St Apt 2f, Boston, MA 02114-4238 | 2019-04-25 |
| 1649645201 | Andrew R Phenix | Physician Assistant | 75 Francis Street, Pbb-b 428, Brigham and Women's Hospital, Boston, MA 02115 | 2015-12-08 |
| 1346636123 | Julie Baskind Gilman | Physician Assistant | 800 Washington St # 401, Tufts Gma, Boston, MA 02111-1552 | 2015-04-08 |
| 1356688030 | Kevin Murtha | Physician Assistant | 6225 Shero Rd, Boston, NY 14025-9707 | 2013-01-15 |
| 1750560348 | Gretchen Haley Biggins | Physician Assistant | 44 Binney St # D1b30, Boston, MA 02115-6013 | 2007-10-30 |
| 1538290549 | Stephen Herrington Robinson | Physician Assistant | One Boston Medical Place, Boston, MA 02118 | 2007-03-08 |
| 1518057306 | Maha B Lund | Physician Assistant | 75 Francis St # Pbb-b4, Boston, MA 02115-6110 | 2006-10-13 |
| 1346287067 | Kathleen Fischer | Physician Assistant | 150 South Huntington Ave., Va Boston Healthcare System, Boston, MA 02130 | 2006-06-01 |
| 1255941548 | Joseph Maglio | Physician Assistant | 637 Washington St, Boston, MA 02124-3510 | 2020-08-03 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.