1609801091 NPI number — HEIDI PAM CORDI MD

Table of content: HEIDI PAM CORDI MD (NPI 1609801091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609801091 NPI number — HEIDI PAM CORDI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORDI
Provider First Name:
HEIDI
Provider Middle Name:
PAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLEISCHMANN
Provider Other First Name:
HEIDI
Provider Other Middle Name:
PAM
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609801091
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/19/2006
NPI Reactivation Date:
10/02/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
622 W 168 ST PH 1 137
Provider Second Line Business Mailing Address:
ASSOCIATES IN EMERGENCY SERVICES CUMC
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10032-3784
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-305-2995
Provider Business Mailing Address Fax Number:
212-305-6792

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
622 W 168 ST PH 1 137
Provider Second Line Business Practice Location Address:
COLUMBIA UNIVERSITY MED CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-3784
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-2995
Provider Business Practice Location Address Fax Number:
212-305-6792
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  188380 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01847070 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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