Provider Demographics
NPI:1881671410
Name:CORTEGIANO, LOUIS JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:JOHN
Last Name:CORTEGIANO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 HUNT LN
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2822
Mailing Address - Country:US
Mailing Address - Phone:917-885-1633
Mailing Address - Fax:
Practice Address - Street 1:818 HUNT LN
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2822
Practice Address - Country:US
Practice Address - Phone:917-884-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-24
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics