Healthcare Provider Details

I. General information

NPI: 1760329189
Provider Name (Legal Business Name): BREANA CORDEIRO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 STATE RD
NORTH DARTMOUTH MA
02747-4302
US

IV. Provider business mailing address

382 STATE RD
NORTH DARTMOUTH MA
02747-4302
US

V. Phone/Fax

Practice location:
  • Phone: 508-717-0425
  • Fax:
Mailing address:
  • Phone: 508-717-0425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT8386
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: