Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 175956 | NY |
NPI | 1871634006 |
---|---|
Provider Name | Dr. Jaime Luis Cortes |
First Address | Bronx, NY 10471-2042 |
Second Address | New York, NY 10033-3726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01391280 | (05) | NY |
E87465 | (02) |