Provider Demographics
NPI:1316417884
Name:PADRON-CORDOVA, ADRIANA ALEXANDRA (OTR)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:ALEXANDRA
Last Name:PADRON-CORDOVA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2254 84TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3328
Mailing Address - Country:US
Mailing Address - Phone:718-419-6268
Mailing Address - Fax:
Practice Address - Street 1:2254 84TH ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3328
Practice Address - Country:US
Practice Address - Phone:718-419-6268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023172225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist