Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 22D102436200 | NJ |
N | 1223P0221X | Pediatric Dentist | 558983-1 | NY |
Y | 1223P0221X | Pediatric Dentist | DS041188 | PA |
N | 1223P0221X | Pediatric Dentist | GI-0001307 | DE |
NPI | 1083848931 |
---|---|
Provider Name | Dr. Maria Cristina Cordero-Ricardo |
First Address | Philadelphia, PA 19130-3863 |
Second Address | Philadelphia, PA 19130-3863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2009 |
Last Update Date | 30/03/2021 |