Provider Demographics
NPI:1235359910
Name:HARTSTEIN, GILA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GILA
Middle Name:
Last Name:HARTSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:GILA
Other - Middle Name:
Other - Last Name:HEIMOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:754 LONGACRE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2354
Mailing Address - Country:US
Mailing Address - Phone:516-295-1631
Mailing Address - Fax:516-295-1631
Practice Address - Street 1:754 LONGACRE AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2354
Practice Address - Country:US
Practice Address - Phone:516-295-1631
Practice Address - Fax:516-295-1631
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011391-1103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily