Provider Demographics
NPI:1134156417
Name:CORTES ROGERS, CECILIA M (MD)
Entity type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:M
Last Name:CORTES ROGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-9279
Mailing Address - Country:US
Mailing Address - Phone:814-693-9855
Mailing Address - Fax:
Practice Address - Street 1:1301 ALLEGHENY ST
Practice Address - Street 2:STE 131
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-2455
Practice Address - Country:US
Practice Address - Phone:814-693-9855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067405L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0818197Medicaid
PA559444OtherHIGHMARK
026145Medicare ID - Type Unspecified
DO6191Medicare UPIN