Provider Demographics
NPI:1750009270
Name:TOLIVER, CORTNEY (M ED)
Entity type:Individual
Prefix:MS
First Name:CORTNEY
Middle Name:
Last Name:TOLIVER
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MANHATTAN AVE APT 1G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2624
Mailing Address - Country:US
Mailing Address - Phone:347-954-7056
Mailing Address - Fax:
Practice Address - Street 1:220 MANHATTAN AVE APT 1G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2624
Practice Address - Country:US
Practice Address - Phone:347-954-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No252Y00000XAgenciesEarly Intervention Provider Agency