Provider Demographics
NPI:1346669728
Name:CUNNINGHAM, COURTNEY AILEEN (MD)
Entity type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:AILEEN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-663-0900
Mailing Address - Fax:732-663-0901
Practice Address - Street 1:1900 RTE 35 STE 200
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2758
Practice Address - Country:US
Practice Address - Phone:732-663-0900
Practice Address - Fax:732-663-0901
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA10899300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program