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NPI Code Detail

MEDICARE: DR. MARIA CRISTINA CORDERO-RICARDO D.M.D

MEDICARE: DR. MARIA CRISTINA CORDERO-RICARDO D.M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry22D102436200NJ
21223P0221XPediatric Dentistry558983-1NY
31223P0221XPediatric DentistryGI-0001307DE
41223P0221XPediatric DentistryDS041188PA

General Provider Information

NPI Number : 1083848931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIA CRISTINA CORDERO-RICARDO D.M.D
Provider Business Mailing Address
First Line : 2000 HAMILTON ST STE 304
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-3863
Country : US
Telephone Number : 267-507-1064
Fax Number :
Provider Business Practice Location Address
First Line : 2000 HAMILTON ST STE 304
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-3863
Country : US
Telephone Number : 267-507-1064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2009
Last Update Date : 03/30/2021

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