Healthcare Provider Details

I. General information

NPI: 1104872225
Provider Name (Legal Business Name): KORDAI I DECOTEAU DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 GARDEN CITY DR STE 304
HYATTSVILLE MD
20785-6105
US

IV. Provider business mailing address

4301 GARDEN CITY DR STE 304
HYATTSVILLE MD
20785-6105
US

V. Phone/Fax

Practice location:
  • Phone: 301-235-0060
  • Fax: 240-324-7720
Mailing address:
  • Phone: 301-235-0060
  • Fax: 240-324-7720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005951 1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01819
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: