Individual
ANDREA CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4 SMITH HAVEN MALL STE 105, LAKE GROVE, NY 11755-1219
(631) 444-2599
Mailing address
47 FOREST AVE, LAKE GROVE, NY 11755-1528
(631) 379-5520
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
623051
NY
Other
Enumeration date
06/23/2015
Last updated
02/18/2026
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