Individual
MS. COURTNEY JO LINA MOREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 WESTAGE BUSINESS CTR DR, FISHKILL, NY 12524-2223
(845) 765-0125
(845) 765-0128
Mailing address
72 MAILLER AVE, CORNWALL, NY 12518-1337
(845) 220-8982
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016627-1
NY
Other
Enumeration date
07/12/2013
Last updated
12/02/2021
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