Individual provider · Type 1 NPI

Ivani Susana Proano-Cordova, DO

Student in an Organized Health Care Education/Training Program · Flushing, NY

NPI number 1558059907 Active

Practice location

5644 Main St
Flushing, NY 11355-5046

Call (718) 670-1347 Map

Fax (718) 670-2456

Mailing address

5645 Main St
Flushing, NY 11355-5045

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1558059907

Ivani Susana Proano-Cordova, DO's National Provider Identifier is 1558059907, issued on Apr 25, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Flushing, NY. The record was last updated on Apr 25, 2023.