Provider Demographics
NPI:1790004372
Name:CORTESE, ROCCO JOHN (NP)
Entity Type:Individual
Prefix:MR
First Name:ROCCO
Middle Name:JOHN
Last Name:CORTESE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1613
Mailing Address - Country:US
Mailing Address - Phone:516-877-2626
Mailing Address - Fax:516-877-0945
Practice Address - Street 1:1401 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1613
Practice Address - Country:US
Practice Address - Phone:516-877-2626
Practice Address - Fax:516-877-0945
Is Sole Proprietor?:No
Enumeration Date:2010-05-22
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336075-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily