Provider Demographics
NPI:1023859329
Name:CORDERO, NYURKA NICOLE
Entity type:Individual
Prefix:
First Name:NYURKA
Middle Name:NICOLE
Last Name:CORDERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 TOWER BLVD APT 820
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3083
Mailing Address - Country:US
Mailing Address - Phone:787-597-6377
Mailing Address - Fax:
Practice Address - Street 1:5198 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1331
Practice Address - Country:US
Practice Address - Phone:787-597-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator