Provider Demographics
NPI:1225754948
Name:CORTEZ, LETISHA (MS,GC)
Entity Type:Individual
Prefix:
First Name:LETISHA
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MS,GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 NEW SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3795
Mailing Address - Country:US
Mailing Address - Phone:518-262-2677
Mailing Address - Fax:
Practice Address - Street 1:22 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3795
Practice Address - Country:US
Practice Address - Phone:518-262-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS