Provider Demographics
NPI:1235391848
Name:HARTL, GERDA (MD)
Entity Type:Individual
Prefix:
First Name:GERDA
Middle Name:
Last Name:HARTL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GERDA
Other - Middle Name:HARTL
Other - Last Name:STRIKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4 HORIZON RD.
Mailing Address - Street 2:APT. G-05
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6716
Mailing Address - Country:US
Mailing Address - Phone:201-224-0776
Mailing Address - Fax:201-224-0776
Practice Address - Street 1:4 HORIZON RD.
Practice Address - Street 2:APT. G-05
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6716
Practice Address - Country:US
Practice Address - Phone:201-224-0776
Practice Address - Fax:201-224-0776
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA025305002084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6256309Medicaid
NJ421548Medicare PIN
NJ6256309Medicaid