Individual
COURTNEY STAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9601 SHORE RD, APT. 4H, BROOKLYN, NY 11209-7651
(917) 821-9611
Mailing address
9601 SHORE RD, APT. 4H, BROOKLYN, NY 11209-7651
(917) 821-9611
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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