Provider Demographics
NPI:1861449241
Name:CORDISCHI, KEITH M (DO)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:M
Last Name:CORDISCHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 LAKE ARIEL HWY
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-7602
Mailing Address - Country:US
Mailing Address - Phone:570-647-0001
Mailing Address - Fax:
Practice Address - Street 1:3202 LAKE ARIEL HWY
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-7602
Practice Address - Country:US
Practice Address - Phone:570-647-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014621207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery