Individual
JOSE RAUL CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1979 MARCUS AVE STE 206, NEW HYDE PARK, NY 11042-1002
(516) 243-8711
Mailing address
16075 NW 64TH AVE APT 108, MIAMI LAKES, FL 33014-7529
(786) 285-7557
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
009934
NY
152W00000X
Optometrist
Primary
1100
NH
152W00000X
Optometrist
OPC6891
FL
Other
Enumeration date
02/27/2024
Last updated
03/20/2026
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