MEDICARE: RAFAEL CORDOVA

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	208100000X	Physical Medicine & Rehabilitation Physician	3565	CT

General Provider Information

NPI Number	:	1992647960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL CORDOVA

Provider Business Mailing Address
First Line	:	1032 NEIPSIC RD
Second Line	:
City	:	GLASTONBURY
State	:	CT
Zip	:	06033-2573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 WESTERN BLVD
Second Line	:
City	:	GLASTONBURY
State	:	CT
Zip	:	06033-4380
Country	:	US
Telephone Number	:	860-549-8288
Fax Number	:

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “ RAFAEL CORDOVA ” Practice Location

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