Healthcare Provider Details

I. General information

NPI: 1013454099
Provider Name (Legal Business Name): COURTNEY LIEBOWITZ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY PILNICK PA-C

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 W END AVE
OLD GREENWICH CT
06870-1642
US

IV. Provider business mailing address

8 W END AVE
OLD GREENWICH CT
06870-1642
US

V. Phone/Fax

Practice location:
  • Phone: 203-637-3212
  • Fax:
Mailing address:
  • Phone: 203-637-3212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number23 020581
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5044
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: