MEDICARE: KOURTNEY SENATORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC06117200	NJ

General Provider Information

NPI Number	:	1114735867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOURTNEY SENATORE

Provider Business Mailing Address
First Line	:	671 HOES LN W
Second Line	:
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-8021
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 HIGH ST
Second Line	:
City	:	CARTERET
State	:	NJ
Zip	:	07008-2653
Country	:	US
Telephone Number	:	732-541-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2024
Last Update Date	:	12/27/2024

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Directions to “ KOURTNEY SENATORE ” Practice Location

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