Provider Demographics
NPI:1184774572
Name:CORDES, JOHN ANDREW (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:CORDES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:77 FORT AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2276
Mailing Address - Country:US
Mailing Address - Phone:518-793-1137
Mailing Address - Fax:
Practice Address - Street 1:578 AVIATION RD
Practice Address - Street 2:STERLING OPTICAL AVIATION MALL
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1814
Practice Address - Country:US
Practice Address - Phone:518-793-5155
Practice Address - Fax:518-745-8140
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004105152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist