Provider Demographics
NPI:1255539094
Name:CASE, COURTNEY LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:LYNN
Last Name:CASE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:39 GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3641
Mailing Address - Country:US
Mailing Address - Phone:917-937-1010
Mailing Address - Fax:
Practice Address - Street 1:501 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1758
Practice Address - Country:US
Practice Address - Phone:631-866-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007226152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist