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NPI Code Detail

MEDICARE: MR. JAMES JOSEPH CORDARO JR. PT

MEDICARE: MR. JAMES JOSEPH CORDARO JR. PT
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
12251X0800XOrthopedic Physical Therapist0231391NY
2225100000XPhysical Therapist023139NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4RA5084OTHERNYMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1103116FTOTHERNYPREFERRED CARE
2P010023139OTHERNYBLUE CHOICE
37344272OTHERNYAETNA

General Provider Information

NPI Number : 1376618165
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES JOSEPH CORDARO JR. PT
Provider Business Mailing Address
First Line : PO BOX 725
Second Line :
City : MENDON
State : NY
Zip : 14506-0725
Country : US
Telephone Number : 585-825-6273
Fax Number :
Provider Business Practice Location Address
First Line : 515 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-3005
Country : US
Telephone Number : 585-227-2310
Fax Number : 585-227-2312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 04/08/2021

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