Provider Demographics
NPI:1477870392
Name:CORTESE, MARYBETH (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:MARYBETH
Middle Name:
Last Name:CORTESE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 VAUGHN RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-1219
Mailing Address - Country:US
Mailing Address - Phone:518-681-4465
Mailing Address - Fax:518-747-3502
Practice Address - Street 1:47 VAUGHN RD
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1219
Practice Address - Country:US
Practice Address - Phone:518-681-4465
Practice Address - Fax:518-747-3502
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335173-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse