Healthcare Provider Details

I. General information

NPI: 1205889425
Provider Name (Legal Business Name): GENYS ISABEL CORDERO-BELLO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 DEVONSHIRE PL NW AB
WASHINGTON DC
20008-3479
US

IV. Provider business mailing address

11306 BERGER TER
POTOMAC MD
20854-2017
US

V. Phone/Fax

Practice location:
  • Phone: 202-667-3340
  • Fax: 202-667-3341
Mailing address:
  • Phone: 301-299-7218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD25971
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: