Provider Demographics
NPI:1255720140
Name:WINTER, COURTNEY ELIZABETH (L AC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:WINTER
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:113 NICKEL AVE
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1761
Mailing Address - Country:US
Mailing Address - Phone:732-309-6672
Mailing Address - Fax:
Practice Address - Street 1:499 MARLBORO RD STE 4
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3746
Practice Address - Country:US
Practice Address - Phone:732-309-6672
Practice Address - Fax:732-705-1225
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00098700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist