Provider Demographics
NPI:1275772105
Name:RILEY, CORTNEY CATHERINE (DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:CORTNEY
Middle Name:CATHERINE
Last Name:RILEY
Suffix:
Gender:F
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 MENDHAM RD
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:NJ
Mailing Address - Zip Code:07934-2121
Mailing Address - Country:US
Mailing Address - Phone:973-285-7613
Mailing Address - Fax:973-267-1716
Practice Address - Street 1:1806 SPRINGFIELD AVE STE 1
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1005
Practice Address - Country:US
Practice Address - Phone:908-771-0707
Practice Address - Fax:908-263-7160
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01169700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist