Provider Demographics
NPI:1275850232
Name:CRAIG, COURTNEY C (DC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:C
Last Name:CRAIG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 LEXINGTON AVE
Mailing Address - Street 2:249
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6823
Mailing Address - Country:US
Mailing Address - Phone:212-802-1446
Mailing Address - Fax:212-253-4044
Practice Address - Street 1:192 LEXINGTON AVE
Practice Address - Street 2:249
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6823
Practice Address - Country:US
Practice Address - Phone:212-802-1446
Practice Address - Fax:212-253-4044
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010179111N00000X
NY011977111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor