Healthcare Provider Details

I. General information

NPI: 1982146015
Provider Name (Legal Business Name): NIKHIL CORDEIRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W 168TH ST
NEW YORK NY
10032-3725
US

IV. Provider business mailing address

150 E 42ND ST FL 9
NEW YORK NY
10017-5699
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-7060
  • Fax:
Mailing address:
  • Phone: 646-605-8186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number301072
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number301072
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number301072
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: