Demetrio Santiago Cornelio, PT

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

017865 Issued in NY

Practice address

1818 Holland Ave
Bronx, NY 10462-3625

Phone

(347) 657-0162

NPI assigned

Jul 26, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1467765982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HOLLAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104623625",
            "telephone_number": "347-657-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 HOLLAND AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104623625",
            "telephone_number": "347-657-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELIO",
        "first_name": "DEMETRIO",
        "middle_name": "SANTIAGO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-26",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "017865",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "017865",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "017865",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "017865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimali Qutina Corley
• Andrea Cornachio, LCSW
• Evelyn Cornejo
• Cornel Dumitriu MD
• Cyrille Kae Cornelio
• Divina Dacanay Cornelio, PHYSICAL THERAPIST
• Kevin Cornelio, MD
• Jessica Cornelius
• Tamutamu Cornelius
• Cornerstone Social Services, Inc

• Geriatric Physical Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Geriatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.