Provider Demographics
NPI:1861629602
Name:EGE, CORTNEY (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:EGE
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:CORTNEY
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:1400 DELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1714
Mailing Address - Country:US
Mailing Address - Phone:443-631-6854
Mailing Address - Fax:
Practice Address - Street 1:3336 WILKENS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229
Practice Address - Country:US
Practice Address - Phone:410-525-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06001225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist