Individual
DIEGO A CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 BROADHOLLOW RD, MELVILLE, NY 11747-4822
(631) 385-7780
Mailing address
225 BROADHOLLOW RD, MELVILLE, NY 11747-4822
(631) 385-7780
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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