Cornell, Alexandra Gately

Cornell, Alexandra Gately is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Ohsu Pediatrics, Portland OR 97239-3011. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Pulmonology. Allopathic & Osteopathic Physicians / Pediatric Pulmonology is her primary health care specialty. Cornell, Alexandra Gately can be contacted via phone (503) 494-5476.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Ohsu Pediatrics Portland OR 97239-3011
Phone: (503) 494-5476
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 249817 New York
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 15287 New Hampshire
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 161586 Oregon

Profile Details

NPI number 1164580486
LBN Legal business name Cornell, Alexandra Gately
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Mar 15th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164580486 NPPES
New Hampshire MEDICAID 32000767

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