Provider Demographics
NPI:1043432727
Name:GORIG, AVIVA DANNIELLE (MD)
Entity Type:Individual
Prefix:
First Name:AVIVA
Middle Name:DANNIELLE
Last Name:GORIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:80 N MOORE ST
Mailing Address - Street 2:# 6C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:917-655-0951
Mailing Address - Fax:212-966-1496
Practice Address - Street 1:227 EAST 19TH STREET
Practice Address - Street 2:9TH FLOOR D BUILDING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-995-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY24346412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry