Provider Demographics
NPI:1326674847
Name:CORTELING, ALEISTER
Entity Type:Individual
Prefix:
First Name:ALEISTER
Middle Name:
Last Name:CORTELING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5257 BUCKEYSTOWN PIKE # 122
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7535
Mailing Address - Country:US
Mailing Address - Phone:655-427-5377
Mailing Address - Fax:
Practice Address - Street 1:22880 WHELAN LN
Practice Address - Street 2:
Practice Address - City:BOYDS
Practice Address - State:MD
Practice Address - Zip Code:20841-9011
Practice Address - Country:US
Practice Address - Phone:240-344-9273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472R0900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherRenal Dialysis