Provider Demographics
NPI:1225400542
Name:TEPEDINO, COURTNEY (WHNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:TEPEDINO
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 STEINWAY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4820
Mailing Address - Country:US
Mailing Address - Phone:718-698-6700
Mailing Address - Fax:718-698-6710
Practice Address - Street 1:209 STEINWAY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4820
Practice Address - Country:US
Practice Address - Phone:718-698-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421207363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health