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Individual
COURTNEY DEJESUS
Active
Individual
COURTNEY DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
014802
NY
363AS0400X
Surgical Physician Assistant
Primary
014802
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03500869
—
NY
Enumeration date
06/22/2011
Last updated
07/16/2025
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