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NPI Code Detail

MEDICARE: COURTNEY MOLTZEN DO

MEDICARE: COURTNEY MOLTZEN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1801303821
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY MOLTZEN DO
Provider Business Mailing Address
First Line : 462 GRIDER ST
Second Line :
City : BUFFALO
State : NY
Zip : 14215-3098
Country : US
Telephone Number : 716-898-3000
Fax Number :
Provider Business Practice Location Address
First Line : 462 GRIDER ST
Second Line :
City : BUFFALO
State : NY
Zip : 14215-3098
Country : US
Telephone Number : 716-898-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2017
Last Update Date : 05/27/2026

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