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NPI Code Detail

MEDICARE: DR. COURTNEY RAY PHD

MEDICARE:  DR. COURTNEY  RAY  PHD
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
1103T00000XPsychologist35SI00601500NJ
2103G00000XClinical Neuropsychologist35SI00601500NJ

General Provider Information

NPI Number : 1346899010
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COURTNEY RAY PHD
Provider Business Mailing Address
First Line : 1300 AVENUE AT PORT IMPERIAL APT 443
Second Line :
City : WEEHAWKEN
State : NJ
Zip : 07086-6967
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 HUDSON ST FL 21
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07302-3929
Country : US
Telephone Number : 914-297-9187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2019
Last Update Date : 06/21/2021

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Directions to “ DR. COURTNEY RAY PHD” Practice Location

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