MEDICARE: MISS MARIA FE MANSO CORDERO

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	225X00000X	Occupational Therapist	015003	NY

General Provider Information

NPI Number	:	1679880603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARIA FE MANSO CORDERO

Provider Business Mailing Address
First Line	:	8204 54TH AVE
Second Line	:	3RD FLOOR
City	:	ELMHURST
State	:	NY
Zip	:	11373-4712
Country	:	US
Telephone Number	:	347-510-4388
Fax Number	:

Provider Business Practice Location Address
First Line	:	3310 QUEENS BLVD
Second Line	:	301
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-2302
Country	:	US
Telephone Number	:	718-593-4121
Fax Number	:

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

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	12/04/2019

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Directions to “ MISS MARIA FE MANSO CORDERO ” Practice Location

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