Provider Demographics
NPI:1093805376
Name:GENSLER, DANIEL ARTHUR (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ARTHUR
Last Name:GENSLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1758
Mailing Address - Country:US
Mailing Address - Phone:516-326-2864
Mailing Address - Fax:516-358-7050
Practice Address - Street 1:20 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2122
Practice Address - Country:US
Practice Address - Phone:516-773-4504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006962-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV22941Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST
NYV22942Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST