Provider Demographics
NPI:1770991051
Name:CONNORS, CORI WINIFRED (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CORI
Middle Name:WINIFRED
Last Name:CONNORS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CORI
Other - Middle Name:WINIFRED
Other - Last Name:SINNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, ATL
Mailing Address - Street 1:3737 MARKET ST FL 8
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5545
Mailing Address - Country:US
Mailing Address - Phone:215-662-3340
Mailing Address - Fax:215-222-8875
Practice Address - Street 1:3737 MARKET ST FL 8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5545
Practice Address - Country:US
Practice Address - Phone:215-662-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260021562255A2300X
PAMA064113363AM0700X, 363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical