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General NPI Number Information
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NPI Number | 1801603576
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Entity Type | Organization
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Legal Business Name | CORTEX GROUP LLC
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 265 POST RD W
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City | WESTPORT
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State | CT
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Zip | 06880-4746
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Country | US
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Telephone | 917-453-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 265 POST RD W
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City | WESTPORT
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State | CT
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Zip | 06880-4746
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Country | US
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Telephone | 917-453-1081
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Fax |
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Authorized Official
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Title or Position | CHAIR
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Name | KENNETH H SHUBIN STEIN
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Credential | MD
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Telephone | 917-453-1081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0301X
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Taxonomy Name | Brain Injury Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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