Provider Demographics
NPI:1023366523
Name:GARTENHAUS, YEHUDA
Entity Type:Individual
Prefix:MR
First Name:YEHUDA
Middle Name:
Last Name:GARTENHAUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 37TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1944
Mailing Address - Country:US
Mailing Address - Phone:718-633-4747
Mailing Address - Fax:
Practice Address - Street 1:1205 37TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1944
Practice Address - Country:US
Practice Address - Phone:718-633-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1156515174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist