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General NPI Number Information
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NPI Number | 1508245366
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Entity Type | Individual
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Provider Name | COURTNEY MAUREEN LOFTUS PA-C, ATC
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 176 3RD AVE
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City | NEW YORK
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State | NY
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Zip | 10003-2520
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Country | US
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Telephone | 800-321-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 925 CHESTNUT ST FL 5
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4290
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT005682
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1146529
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 022970
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License Number State | NY
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