Individual
MR. CHARLES CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHC-LP
Contact information
Practice address
248 W 108TH ST, THE BRIDGE 5TH FL CLINIC, NEW YORK, NY 10025-2956
(718) 542-8080
Mailing address
248 W 108TH ST, THE BRIDGE 5TH FL CLINIC, NEW YORK, NY 10025-2956
(718) 542-8080
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P03157
NY
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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