Provider Demographics
NPI:1265719470
Name:CORNETT, JUNE
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:CORNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 SAINT MARKS PL
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2417
Mailing Address - Country:US
Mailing Address - Phone:718-727-3303
Mailing Address - Fax:718-448-0509
Practice Address - Street 1:358 SAINT MARKS PL
Practice Address - Street 2:4TH FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2417
Practice Address - Country:US
Practice Address - Phone:718-727-3303
Practice Address - Fax:718-448-0509
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management