Provider Demographics
NPI:1801150818
Name:CAREY, CORTNEY
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:CAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 51ST ST
Mailing Address - Street 2:APT 6C
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3153
Mailing Address - Country:US
Mailing Address - Phone:516-263-4160
Mailing Address - Fax:
Practice Address - Street 1:3945 51ST ST
Practice Address - Street 2:APT 6C
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3153
Practice Address - Country:US
Practice Address - Phone:516-263-4160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58 021131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist