Healthcare Provider Details

I. General information

NPI: 1245777606
Provider Name (Legal Business Name): ALEXIS CORTESE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIS DEANA-ROGA

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 FELLOWSHIP RD
BASKING RIDGE NJ
07920-3915
US

IV. Provider business mailing address

8000 FELLOWSHIP RD
BASKING RIDGE NJ
07920-3915
US

V. Phone/Fax

Practice location:
  • Phone: 908-340-3350
  • Fax:
Mailing address:
  • Phone: 908-872-9492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00428500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: