Provider Demographics
NPI:1700932480
Name:CORDARO, ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:CORDARO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 TOLEDO TER
Mailing Address - Street 2:SUITE C-101
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-4135
Mailing Address - Country:US
Mailing Address - Phone:301-559-3511
Mailing Address - Fax:
Practice Address - Street 1:3311 TOLEDO TER
Practice Address - Street 2:SUITE C-101
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-4135
Practice Address - Country:US
Practice Address - Phone:301-559-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1041213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4320399OtherAETNA PPO PROVIDER NUMBER
MD2212840OtherAETNA HMO PROVIDER NUMBER
DCA9980001OtherCAREFIRST BCBS PROVIDER
MD85457Medicaid
MDT-319OtherCAREFIRST BCBS PROVIDER N
DCA9980001OtherCAREFIRST BCBS PROVIDER
MD156825Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER