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General NPI Number Information
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NPI Number | 1265617310
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Entity Type | Individual
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Provider Name | MARIE ELENA CORDISCO APRN
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Gender | Female
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 25 GERMANTOWN RD
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City | DANBURY
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State | CT
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Zip | 06810-5036
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Country | US
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Telephone | 203-764-5620
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Fax | 203-794-5642
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Provider Business Mailing Address
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Address Line | 25 GERMANTOWN RD
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City | DANBURY
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State | CT
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Zip | 06810-5036
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Country | US
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Telephone | 203-764-5620
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Fax | 203-794-5642
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 46044
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CT 004452
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License Number State | CT
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