Individual
CORDERO JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN RN
Contact information
Practice address
624 DR MARTIN LUTHER KING JR BLVD APT 9, NEWARK, NJ 07102-1254
(917) 657-8363
Mailing address
624 DR MARTIN LUTHER KING JR BLVD APT 9, NEWARK, NJ 07102-1254
(917) 657-8363
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
723035
NY
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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