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General NPI Number Information
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NPI Number | 1346899010
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Entity Type | Individual
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Provider Name | COURTNEY RAY PHD
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 101 HUDSON ST FL 21
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City | JERSEY CITY
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State | NJ
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Zip | 07302-3929
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Country | US
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Telephone | 914-297-9187
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 AVENUE AT PORT IMPERIAL APT 443
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City | WEEHAWKEN
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State | NJ
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Zip | 07086-6967
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35SI00601500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 35SI00601500
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License Number State | NJ
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