Provider Demographics
NPI:1609806751
Name:NYITRAI, COURTNEY CARROLL (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:CARROLL
Last Name:NYITRAI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 ROUTES 5 & 20
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081
Mailing Address - Country:US
Mailing Address - Phone:716-951-7000
Mailing Address - Fax:716-951-7185
Practice Address - Street 1:TLC HEALTH NETWORK
Practice Address - Street 2:845 ROUTES 5 &20
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081
Practice Address - Country:US
Practice Address - Phone:716-951-7000
Practice Address - Fax:716-951-7185
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048770-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist