| Diane M. Cornicelli, M.d. Inc, | |
|
36001 Euclid Ave Suite C-19 Willoughby OH 44094-4643 | |
| (216) 374-9664 | |
| Not Available |
| Full Name | Diane M. Cornicelli, M.d. Inc, |
|---|---|
| Speciality | Internal Medicine |
| Location | 36001 Euclid Ave, Willoughby, Ohio |
| Authorized Official Name and Position | Diane Cornicelli (PRESIDENT) |
| Authorized Official Contact | 2163749664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane M. Cornicelli, M.d. Inc, Po Box 221427 Beachwood OH 44122-0999 Ph: (216) 374-9664 | Diane M. Cornicelli, M.d. Inc, 36001 Euclid Ave Suite C-19 Willoughby OH 44094-4643 Ph: (216) 374-9664 |
| NPI Number | 1164506762 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164506762 | NPI | - | NPPES |
| 0784414 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35056746 (Ohio) | Primary |
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