Provider Demographics
NPI:1932130168
Name:FERREIRA, CORNELIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:CORNELIUS
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6148
Mailing Address - Country:US
Mailing Address - Phone:203-775-6365
Mailing Address - Fax:203-740-3010
Practice Address - Street 1:95 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6148
Practice Address - Country:US
Practice Address - Phone:203-775-6365
Practice Address - Fax:203-740-3010
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400027732Medicare PIN