Provider Demographics
NPI:1821285362
Name:MICHAEL CORTESE
Entity Type:Organization
Organization Name:MICHAEL CORTESE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MA-PSYCHOLOGY
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:CORTESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-583-7540
Mailing Address - Street 1:24 LIMESTONE RD
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-2305
Mailing Address - Country:US
Mailing Address - Phone:917-583-7540
Mailing Address - Fax:
Practice Address - Street 1:24 LIMESTONE RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2305
Practice Address - Country:US
Practice Address - Phone:917-583-7540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities