Provider Demographics
NPI:1063996221
Name:CORTELLA, ALEXIA BAJWA (PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:ALEXIA
Middle Name:BAJWA
Last Name:CORTELLA
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WEDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1792
Mailing Address - Country:US
Mailing Address - Phone:203-914-6765
Mailing Address - Fax:
Practice Address - Street 1:5 WEDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1792
Practice Address - Country:US
Practice Address - Phone:203-914-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-23
Last Update Date:2018-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT78352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry