Provider Demographics
NPI:1407843907
Name:ALCORTA, CARLOS E (MD, FACC)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:ALCORTA
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 79TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4938
Mailing Address - Country:US
Mailing Address - Phone:201-869-3737
Mailing Address - Fax:201-869-4437
Practice Address - Street 1:1009 79TH ST
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4938
Practice Address - Country:US
Practice Address - Phone:201-869-3737
Practice Address - Fax:201-869-4437
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA28843207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0549606Medicaid
NJD92576Medicare UPIN
NJ509307Medicare ID - Type Unspecified