Provider Demographics
NPI:1821875618
Name:CORTES, AWILDA (SPECIAL ED TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:AWILDA
Middle Name:
Last Name:CORTES
Suffix:
Gender:F
Credentials:SPECIAL ED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 E 139TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2601
Mailing Address - Country:US
Mailing Address - Phone:646-325-4611
Mailing Address - Fax:
Practice Address - Street 1:447 E 139TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2601
Practice Address - Country:US
Practice Address - Phone:646-325-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336806031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist