Provider Demographics
NPI:1376618165
Name:CORDARO, JAMES JOSEPH JR (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JOSEPH
Last Name:CORDARO
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0725
Mailing Address - Country:US
Mailing Address - Phone:585-825-6273
Mailing Address - Fax:
Practice Address - Street 1:515 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3005
Practice Address - Country:US
Practice Address - Phone:585-227-2310
Practice Address - Fax:585-227-2312
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02313912251X0800X
NY023139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103116FTOtherPREFERRED CARE
NYP010023139OtherBLUE CHOICE
NY7344272OtherAETNA
NYRA5084OtherMEDICARE PTAN
NY103116FTOtherPREFERRED CARE