Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD423741 | PA |
N | 208600000X | Surgeon | MD423741 | PA |
Y | 2086S0102X | Surgical Critical Care | MD423741 | PA |
NPI | 1144220682 |
---|---|
Provider Name | Dr. Vicente Cortes |
First Address | Philadelphia, PA 19104-2640 |
Second Address | West Reading, PA 19611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 14/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0836028 | (05) | OH |
1010951730001 | (05) | PA |
3810011017 | (05) | WV |
E75826 | (02) | PA |