Organization Active NPI

Isabelita Cordoba,Mdpa

  • Gastroenterology Physician
  • Bayonne, NJ
National Provider Identifier
1992875223
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
ISABELITA CORDOBA,MDPA
Practice address
564 Broadway
Bayonne, NJ 07002-3825
Phone
(201) 436-8418
Fax
(908) 561-1803
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Dr. Isabelita Ynigo Cordoba, M.D.
Title
President
Phone
(201) 436-8418

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

564 Broadway
Bayonne, NJ 07002-3825

Mailing address

39 Stratford Cir
Edison, NJ 08820-1813
Phone (908) 561-1803

Other identifiers 1

IdentifierTypeStateIssuer
2907003MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1992875223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 STRATFORD CIR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088201813",
            "telephone_number": "908-561-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023825",
            "telephone_number": "201-436-8418",
            "fax_number": "908-561-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISABELITA CORDOBA,MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "CORDOBA",
        "authorized_official_first_name": "ISABELITA",
        "authorized_official_middle_name": "YNIGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-436-8418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2907003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.