Provider Demographics
NPI:1386630994
Name:CORTINA, OSVALDO (MD)
Entity Type:Individual
Prefix:
First Name:OSVALDO
Middle Name:
Last Name:CORTINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 38TH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5283
Mailing Address - Country:US
Mailing Address - Phone:201-865-9491
Mailing Address - Fax:201-865-0306
Practice Address - Street 1:322 38TH ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5283
Practice Address - Country:US
Practice Address - Phone:201-865-9491
Practice Address - Fax:201-865-0306
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07689300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I18755Medicare UPIN