Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | APRN.CNP.024428 | OH |
NPI | 1043779911 |
---|---|
Provider Name | Gregory B Cortese |
First Address | Lakewood, OH 44107-3726 |
Second Address | North Ridgeville, OH 44039-3430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 19/03/2019 |