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General NPI Number Information
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NPI Number | 1881080125
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Entity Type | Individual
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Provider Name | ANDREA M CORDERO-REYES MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 2801 W KINNICKINNIC RIVER PKWY STE 438
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City | MILWAUKEE
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State | WI
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Zip | 53215-3678
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Country | US
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Telephone | 414-385-2768
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 W KINNICKINNIC RIVER PKWY STE 438
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City | MILWAUKEE
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State | WI
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Zip | 53215-3678
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Country | US
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Telephone | 143-852-7684
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10055733
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 83770
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License Number State | WI
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