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General NPI Number Information
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NPI Number | 1063543403
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Entity Type | Organization
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Legal Business Name | JON E COURTNEY MDPA
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2733 NOTTINGHAM WAY SUITE 1
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City | TRENTON
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-890-7917
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Fax |
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Provider Business Mailing Address
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Address Line | 2733 NOTTINGHAM WAY SUITE 1
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City | TRENTON
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-890-7917
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JON EARL COURTNEY
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Credential | MD
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Telephone | 609-890-7917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA02096200
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License Number State | NJ
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