Provider Demographics
NPI:1811394471
Name:CORDOVA, ALVARO
Entity Type:Individual
Prefix:MR
First Name:ALVARO
Middle Name:
Last Name:CORDOVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 MIDDLE RD
Mailing Address - Street 2:SUITE #8
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1945
Mailing Address - Country:US
Mailing Address - Phone:732-615-9300
Mailing Address - Fax:
Practice Address - Street 1:226 MIDDLE RD
Practice Address - Street 2:SUITE #8
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1945
Practice Address - Country:US
Practice Address - Phone:732-615-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00354400156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician