Healthcare Provider Details

I. General information

NPI: 1902729676
Provider Name (Legal Business Name): LILIANA CORDERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6218 JERICHO TPKE
COMMACK NY
11725-2801
US

IV. Provider business mailing address

27 HAMLIN AVE
WEST BABYLON NY
11704-2305
US

V. Phone/Fax

Practice location:
  • Phone: 631-499-5437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132190-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: