Healthcare Provider Details

I. General information

NPI: 1124477815
Provider Name (Legal Business Name): CORTES HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E 46TH ST 9TH FLOOR
NEW YORK NY
10017-2417
US

IV. Provider business mailing address

PO BOX 3350
ASTORIA NY
11103-0350
US

V. Phone/Fax

Practice location:
  • Phone: 201-857-4011
  • Fax: 201-389-3498
Mailing address:
  • Phone: 201-857-4011
  • Fax: 201-389-3498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX010394-1
License Number StateNY

VIII. Authorized Official

Name: DR. JOSE CORTES
Title or Position: OWNER
Credential: DC
Phone: 201-857-4011