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General NPI Number Information
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NPI Number | 1760250740
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Entity Type | Individual
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Provider Name | COURTNEY LYNN CLAVETTE
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Gender | Female
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 200 E 33RD ST APT 15G
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City | NEW YORK
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State | NY
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Zip | 10016-4829
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Country | US
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Telephone | 860-681-8388
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Fax |
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Provider Business Mailing Address
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Address Line | 70 GREENE ST APT 1603
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City | JERSEY CITY
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State | NJ
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Zip | 07302-7592
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Country | US
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Telephone | 860-681-8388
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 801545
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | F354010-01
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License Number State | NY
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