1205889425 NPI number — DR. GENYS ISABEL CORDERO-BELLO M.D.

Table of content: DR. GENYS ISABEL CORDERO-BELLO M.D. (NPI 1205889425)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205889425 NPI number — DR. GENYS ISABEL CORDERO-BELLO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORDERO-BELLO
Provider First Name:
GENYS
Provider Middle Name:
ISABEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205889425
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11306 BERGER TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POTOMAC
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20854-2017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-299-7218
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2737 DEVONSHIRE PL NW
Provider Second Line Business Practice Location Address:
AB
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20008-3479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-667-3340
Provider Business Practice Location Address Fax Number:
202-667-3341
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD25971 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6715389 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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