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NPI Code Detail

MEDICARE: MS. MARY C COURTNEY MSN, NP

MEDICARE: MS. MARY C COURTNEY MSN, NP
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
1363LF0000XFamily Nurse Practitioner335456NY

General Provider Information

NPI Number : 1306011325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY C COURTNEY MSN, NP
Provider Business Mailing Address
First Line : 5400 FIELDSTON RD
Second Line : APT 62B
City : RIVERDALE
State : NY
Zip : 10471-2541
Country : US
Telephone Number : 718-601-7639
Fax Number :
Provider Business Practice Location Address
First Line : 1 GUSTAVE L LEVY PL MSH 1458
Second Line : MOUNT SINAI MEDICAL CENTER
City : NEW YORK
State : NY
Zip : 10029
Country : US
Telephone Number : 212-241-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2008
Last Update Date : 04/30/2008

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