Provider Demographics
NPI:1811346174
Name:CORTEZ, WILLIAM JR
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:CORTEZ
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 EMPIRE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6710
Mailing Address - Country:US
Mailing Address - Phone:336-397-2165
Mailing Address - Fax:
Practice Address - Street 1:1255 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:STE 503
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3800
Practice Address - Country:US
Practice Address - Phone:609-581-5250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist