Basic Information
Provider Information
NPI: 1982018982
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CORTESE
FirstName: BARBARA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MA, CCCSLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 278 MORNING GLORY CT
Address2:  
City: WHITEHOUSE STATION
State: NJ
PostalCode: 088892016
CountryCode: US
TelephoneNumber: 9085109287
FaxNumber:  
Practice Location
Address1: 380 DEMOTT LN
Address2:  
City: SOMERSET
State: NJ
PostalCode: 088732762
CountryCode: US
TelephoneNumber: 7328732000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/17/2014
LastUpdateDate: 06/17/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X41YS00366100NJY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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