Anthony Joseph Cornette, AS

Individual provider Active NPI Occupational Therapy Assistant · Lincoln, MA

NPI 1053029322 · NPPES record last updated Nov 7, 2022

Key facts

NPI
1053029322
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
4833 (MA)
Practice address
1 Harvest Cir
Lincoln, MA 01773-3214
Phone
(781) 799-2607
NPI assigned
Nov 7, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Associate of Science

State licenses

LicenseStateTypeSpecialty
4833MAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
224Z00000X 4833 MA Yes

Addresses

Primary practice location

1 Harvest Cir
Lincoln, MA 01773-3214

Mailing address

28 Farragut Ave
Medford, MA 02155-4012
Phone (781) 799-2607

Other providers in Lincoln, MA

All providers in Lincoln, MA · Occupational Therapy Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.