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General NPI Number Information
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NPI Number | 1033764568
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Entity Type | Organization
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Legal Business Name | MANUEL A. CORDERO
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 2 TALON CT
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City | SEWELL
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State | NJ
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Zip | 08080-1680
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Country | US
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Telephone | 856-589-8533
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TALON CT
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City | SEWELL
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State | NJ
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Zip | 08080-1680
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | NIKHIL SAHA
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Credential |
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Telephone | 908-533-4386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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