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General NPI Number Information
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NPI Number | 1902868854
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Entity Type | Individual
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Provider Name | JORGE ALBERTO CORTINA MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 100 EMANCIPATION DR
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City | HAMPTON
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State | VA
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Zip | 23667-0001
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Country | US
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Telephone | 757-722-9961
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Fax |
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Provider Business Mailing Address
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Address Line | 35 DRYDEN DR
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City | POQUOSON
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State | VA
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Zip | 23662-1454
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Country | US
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Telephone | 757-722-9961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 41446
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 41446
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 41446
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License Number State | VA
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