MEDICARE: COURTNEY HARRIGAN

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	235Z00000X	Speech-Language Pathologist		NY

General Provider Information

NPI Number	:	1225533946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY HARRIGAN

Provider Business Mailing Address
First Line	:	30 NATICK ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-1617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 NATICK ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-1617
Country	:	US
Telephone Number	:	718-351-1155
Fax Number	:

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

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	03/26/2018

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Directions to “ COURTNEY HARRIGAN ” Practice Location

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