Provider Demographics
NPI:1255524336
Name:GUERRIERI, COURTNEY BETH (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BETH
Last Name:GUERRIERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST
Mailing Address - Street 2:STE 740
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4414
Mailing Address - Country:US
Mailing Address - Phone:215-955-6680
Mailing Address - Fax:215-503-2556
Practice Address - Street 1:833 CHESTNUT ST
Practice Address - Street 2:STE 740
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4414
Practice Address - Country:US
Practice Address - Phone:215-955-6680
Practice Address - Fax:215-503-2556
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190167207N00000X
PAMD442765207N00000X
DEC1-0009785207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102616945Medicaid
NJ0267261Medicaid
PA223338Medicare PIN