Provider Demographics
NPI:1376781740
Name:CORDERO-NOEL, PERSIA ONDINA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:PERSIA
Middle Name:ONDINA
Last Name:CORDERO-NOEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TEMPO RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1343
Mailing Address - Country:US
Mailing Address - Phone:845-639-4048
Mailing Address - Fax:
Practice Address - Street 1:14 TEMPO RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-1343
Practice Address - Country:US
Practice Address - Phone:845-639-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049870-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker