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Individual

MARIANNA CORDOVANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1090 AMSTERDAM AVE, SUITE 10A, NEW YORK, NY 10025-1737
(212) 523-5222
(212) 523-1761
Mailing address
1090 AMSTERDAM AVE, SUITE 10A, NEW YORK, NY 10025-1737
(212) 523-5222
(212) 523-1761

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3667
CT
363AS0400X
Surgical Physician Assistant
Primary
020501-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04602140
NY
05
1841748456
CT
Enumeration date
09/13/2016
Last updated
02/17/2017
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