Provider Demographics
NPI:1639208762
Name:CORDERO, FRANKLIN II (PT)
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:
Last Name:CORDERO
Suffix:II
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 1:95B NIPMUC TRL
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-7752
Mailing Address - Country:US
Mailing Address - Phone:323-712-0193
Mailing Address - Fax:
Practice Address - Street 1:95B NIPMUC TRL
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-7752
Practice Address - Country:US
Practice Address - Phone:323-712-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29207225100000X
RI2677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist