Individual
MILWIDA CORDOVA GOQUINGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1129 BROAD ST, BLOOMFIELD, NJ 07003-3092
(973) 338-3620
Mailing address
1129 BROAD ST, BLOOMFIELD, NJ 07003-3092
(973) 338-3620
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40QA00477100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
PHYSICAL THERAPIST
—
Enumeration date
01/03/2023
Last updated
01/03/2023
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