Healthcare Provider Details

I. General information

NPI: 1023328440
Provider Name (Legal Business Name): ANTHONY G. CORTESE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1362 UNION STREET
SCHENECTADY NY
12308
US

IV. Provider business mailing address

4 PARKWOOD STREET
ALBANY NY
12203-3626
US

V. Phone/Fax

Practice location:
  • Phone: 518-374-0295
  • Fax: 518-377-3729
Mailing address:
  • Phone: 518-438-3495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR032840-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: