Provider Demographics
NPI:1770529075
Name:CORDIE, TASMIN LEE (DC)
Entity type:Individual
Prefix:DR
First Name:TASMIN
Middle Name:LEE
Last Name:CORDIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 STATE ROUTE 79 N STE 8
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2079
Mailing Address - Country:US
Mailing Address - Phone:732-443-0300
Mailing Address - Fax:732-526-4150
Practice Address - Street 1:242 STATE ROUTE 79 N STE 8
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-2079
Practice Address - Country:US
Practice Address - Phone:732-443-0300
Practice Address - Fax:732-526-4150
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1524652OtherHIGHMARK
PA100902965-0001Medicaid
PA073269R9UMedicare PIN
U97672Medicare UPIN