Provider Demographics
NPI:1376076752
Name:HERNANDEZ-DE CORA, GENIL NOEMI (MD)
Entity Type:Individual
Prefix:DR
First Name:GENIL
Middle Name:NOEMI
Last Name:HERNANDEZ-DE CORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GENIL
Other - Middle Name:H
Other - Last Name:CORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1149 MILLHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1753
Mailing Address - Country:US
Mailing Address - Phone:330-665-1232
Mailing Address - Fax:330-294-4219
Practice Address - Street 1:1149 MILLHAVEN DR
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1753
Practice Address - Country:US
Practice Address - Phone:330-665-1232
Practice Address - Fax:330-294-4219
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078157208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics