Provider Demographics
NPI:1982869392
Name:COURTNEY, PATRICK KEVIN (RPH)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:KEVIN
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 GLENEIDA AVE
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-1211
Mailing Address - Country:US
Mailing Address - Phone:845-225-1038
Mailing Address - Fax:845-228-0257
Practice Address - Street 1:180 GLENEIDA AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1211
Practice Address - Country:US
Practice Address - Phone:845-225-1038
Practice Address - Fax:845-228-0257
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist