Provider Demographics
NPI:1063743219
Name:CORTESE, BERNADETTE M (PHD)
Entity type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:M
Last Name:CORTESE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 PRESIDENT ST
Mailing Address - Street 2:BA 405H
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-5712
Mailing Address - Country:US
Mailing Address - Phone:843-792-6922
Mailing Address - Fax:
Practice Address - Street 1:67 PRESIDENT ST
Practice Address - Street 2:BA 405H
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-5712
Practice Address - Country:US
Practice Address - Phone:843-792-6922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist