MEDICARE: MR. MARIO CORDARO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	208855	NY
2	207V00000X	Obstetrics & Gynecology Physician	25MB10858900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285764506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARIO CORDARO D.O.

Provider Business Mailing Address
First Line	:	55 WATER STREET
Second Line	:	2ND FLOOR CRED DEPT
City	:	NEW YORK
State	:	NY
Zip	:	10041-0004
Country	:	US
Telephone Number	:	646-680-2888
Fax Number	:	516-542-5556

Provider Business Practice Location Address
First Line	:	36 NEWARK AVE STE 220
Second Line	:
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-4121
Country	:	US
Telephone Number	:	973-844-4161
Fax Number	:	973-844-4162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/19/2024

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Directions to “ MR. MARIO CORDARO D.O.” Practice Location

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