Deforest Cornish

NPI #1639731599 in Laurelton, New York

Provider Information

NPI Number
1639731599
Entity Type
Individual
Name
Deforest Cornish
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Early Intervention Provider Agency
Enumeration Date
Jul 1, 2019
Last Updated
Jul 1, 2019

Practice Location

Address
13122 223RD ST
ZIP Code
11413-1646
Phone
(347) 715-0477

Specialties & Taxonomy Codes

Specialty
Early Intervention Provider Agency

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