Healthcare Provider Details

I. General information

NPI: 1487562096
Provider Name (Legal Business Name): ALESSANDRA CORDOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 LONG ST, JERSEY CITY, NJ
JERSEY NJ
07305
US

IV. Provider business mailing address

17 LONG ST, JERSEY CITY, NJ
JERSEY NJ
07305
US

V. Phone/Fax

Practice location:
  • Phone: 908-463-0305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: