Provider Demographics
NPI:1205889425
Name:CORDERO-BELLO, GENYS ISABEL (MD)
Entity type:Individual
Prefix:DR
First Name:GENYS
Middle Name:ISABEL
Last Name:CORDERO-BELLO
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 1:11306 BERGER TER
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2017
Mailing Address - Country:US
Mailing Address - Phone:301-299-7218
Mailing Address - Fax:
Practice Address - Street 1:2737 DEVONSHIRE PL NW
Practice Address - Street 2:AB
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3479
Practice Address - Country:US
Practice Address - Phone:202-667-3340
Practice Address - Fax:202-667-3341
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD25971208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6715389Medicaid