Active NPI
Bryant F Cordova, DPT
- Physical Therapist
- Elizabeth, NJ
National Provider Identifier
1093452013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 59-63 Elmora Ave
Elizabeth, NJ 07201 - Phone
- (908) 436-1039
- NPI assigned
- May 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NJ | Primary |
Addresses
Primary practice location
59-63 Elmora Ave
Elizabeth, NJ 07201
Mailing address
821 Madison Ave
Elizabeth, NJ 07201-1308
Phone (908) 659-8807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1093452013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 MADISON AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072011308",
"telephone_number": "908-659-8807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59-63 ELMORA AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "07201",
"telephone_number": "908-436-1039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "BRYANT",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-19",
"last_updated": "2022-05-19",
"certification_date": "2022-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.