Provider Demographics
NPI:1144227299
Name:CORDES, EDWARD V (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:V
Last Name:CORDES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2255
Mailing Address - Country:US
Mailing Address - Phone:607-973-8265
Mailing Address - Fax:607-937-1089
Practice Address - Street 1:130 CENTER WAY
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2255
Practice Address - Country:US
Practice Address - Phone:607-973-8265
Practice Address - Fax:607-937-1089
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003540152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0598OtherMEDICARE GROUP
PA0019042000001Medicaid
NY00370503Medicaid
NYCC8362OtherRR MEDICARE GROUP
NYAA0598OtherMEDICARE GROUP