Healthcare Provider Details

I. General information

NPI: 1588112411
Provider Name (Legal Business Name): COURTNEY GABRIELLE MONTEROSSO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY VERRECCHIA DO

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 SALEM RD
BURLINGTON TOWNSHIP NJ
08016-2204
US

IV. Provider business mailing address

2006 SALEM RD
BURLINGTON TOWNSHIP NJ
08016-2204
US

V. Phone/Fax

Practice location:
  • Phone: 609-877-1500
  • Fax:
Mailing address:
  • Phone: 609-877-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS019968
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB11205500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: