Individual
MS. COURTNEY CATHERINE CIVITANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1 UNIVERSITY PLZ, WRAC, BROOKLYN, NY 11201-5301
(718) 780-4158
(718) 246-6392
Mailing address
6525 160TH ST, 19D, FRESH MEADOWS, NY 11365-2567
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001724-1
NY
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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