Provider Demographics
NPI:1861014342
Name:CORDERO-COLON, PAOLA N
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:N
Last Name:CORDERO-COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE ST BOX 800699
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0816
Mailing Address - Country:US
Mailing Address - Phone:434-924-8485
Mailing Address - Fax:434-982-4118
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-2347
Practice Address - Country:US
Practice Address - Phone:434-924-8485
Practice Address - Fax:434-982-4118
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program