Cornelia Vandervliet, MA,CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

41YA00004900 Issued in NJ

Practice address

140 Bergen St
Level E Room 1700
Newark, NJ 07103

Phone

(973) 972-9500

Fax

(973) 972-3923

NPI assigned

Apr 27, 2007

Last updated

Dec 6, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1063632354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CHANDA CT",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121936",
            "telephone_number": "973-365-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "address_2": "LEVEL E ROOM 1700",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-972-9500",
            "fax_number": "973-972-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVLIET",
        "first_name": "CORNELIA",
        "name_prefix": "Ms.",
        "credential": "MA,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00004900",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NJ",
            "license": "25MG00045400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Newark, NJ
• Providers in Newark, NJ by specialty
• Audiologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.