Provider Demographics
NPI:1609040807
Name:CORTI, JOANNA (DOM)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:CORTI
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 W SAN FRANCISCO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-1941
Mailing Address - Country:US
Mailing Address - Phone:505-989-1460
Mailing Address - Fax:505-424-7878
Practice Address - Street 1:439 W SAN FRANCISCO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-1941
Practice Address - Country:US
Practice Address - Phone:505-989-1460
Practice Address - Fax:505-424-7878
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM329171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist