Provider Demographics
NPI:1902255144
Name:GERMANO, COURTNEY
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:GERMANO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:GERMANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:192 RAY RD
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242-6159
Mailing Address - Country:US
Mailing Address - Phone:603-724-7609
Mailing Address - Fax:
Practice Address - Street 1:28 COMMERCIAL ST
Practice Address - Street 2:SUITE 4
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5091
Practice Address - Country:US
Practice Address - Phone:603-225-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4087208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0000000000Medicare NSC