Provider Demographics
NPI:1629244967
Name:CORDERO, PAMELA DELA TORRE (APN,C)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DELA TORRE
Last Name:CORDERO
Suffix:
Gender:F
Credentials:APN,C
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:VERGARA
Other - Last Name:DELA TORRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:77 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2207
Mailing Address - Country:US
Mailing Address - Phone:973-857-1211
Mailing Address - Fax:
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00158600363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care