Provider Demographics
NPI:1427842640
Name:CORNIEL, RICARDO ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:ANTONIO
Last Name:CORNIEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6227 DE COSTA AVE
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1335
Mailing Address - Country:US
Mailing Address - Phone:347-874-8056
Mailing Address - Fax:
Practice Address - Street 1:6227 DE COSTA AVE
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1335
Practice Address - Country:US
Practice Address - Phone:347-874-8056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program