Provider Demographics
NPI:1013356377
Name:GHARTEY, EUGENIA E (MSED)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:E
Last Name:GHARTEY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1316
Mailing Address - Country:US
Mailing Address - Phone:347-233-0243
Mailing Address - Fax:
Practice Address - Street 1:21 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1316
Practice Address - Country:US
Practice Address - Phone:347-233-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1152082174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY931830905OtherGHI