Mary Antonette Evangelista Cordon, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI03890300 Issued in NJ

Practice address

267 Grant St
Bridgeport, CT 06610-2870

Phone

(203) 384-3000

NPI assigned

Sep 11, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Dr. Mary Antonette Cordon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1407461890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MATHER ST APT 6414",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143199",
            "telephone_number": "201-365-8136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102870",
            "telephone_number": "203-384-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Park St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065115474",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANGELISTA CORDON",
        "first_name": "MARY",
        "middle_name": "ANTONETTE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202217006",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PTP.0000548",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03890300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT BOARD OF PHARMACY",
            "identifier": "PTP.0000548",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF PHARMACY",
            "identifier": "0202217006",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY BOARD OF PHARMACY",
            "identifier": "28RI03890300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CORDON",
            "middle_name": "ANTONETTE",
            "prefix": "DR.",
            "credential": "PHARMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Santiago Escobar, M.D.
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• Cleofas Espinoza, CRNA
• Cassandra Esposito, NP
• Lindsay Estel, OD
• Lachanna R Evans-Cabrera, APRN
• Joyce Evans, LPC
• Mary Louise Evans
• Kelly Everlith, APRN, FNP-BC
• Everroot Counseling LLC

• Pharmacist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.