Provider Demographics
NPI:1235845074
Name:CORNEA, ANDRADA ALEXANDRA (BAED)
Entity type:Individual
Prefix:
First Name:ANDRADA
Middle Name:ALEXANDRA
Last Name:CORNEA
Suffix:
Gender:F
Credentials:BAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 SHORE RD APT 5C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1055
Mailing Address - Country:US
Mailing Address - Phone:917-974-6088
Mailing Address - Fax:
Practice Address - Street 1:6911 SHORE RD APT 5C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1055
Practice Address - Country:US
Practice Address - Phone:917-974-6088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist