Provider Demographics
NPI:1487977591
Name:CORNETT, ORIANA ELLEN (MD)
Entity type:Individual
Prefix:
First Name:ORIANA
Middle Name:ELLEN
Last Name:CORNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN STREET
Mailing Address - Street 2:XAVIER RM 623
Mailing Address - City:PATTERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2425
Mailing Address - Country:US
Mailing Address - Phone:973-754-2464
Mailing Address - Fax:
Practice Address - Street 1:90 BERGEN ST
Practice Address - Street 2:D.O.C. SUITE 8100
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-9274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA084412002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology