Provider Demographics
NPI:1699813279
Name:CORDEIRO, PATRICIA MARIE (ATC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:CORDEIRO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4302
Mailing Address - Country:US
Mailing Address - Phone:781-910-9466
Mailing Address - Fax:617-627-2185
Practice Address - Street 1:161 COLLEGE AVE
Practice Address - Street 2:TUFTS UNIVERSITY
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5528
Practice Address - Country:US
Practice Address - Phone:617-627-5102
Practice Address - Fax:617-627-2185
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA543174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist