Provider Demographics
NPI:1376593301
Name:GRETZ, HERBERT III (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:
Last Name:GRETZ
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2574
Mailing Address - Country:US
Mailing Address - Phone:914-305-2730
Mailing Address - Fax:914-305-2731
Practice Address - Street 1:3030 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2574
Practice Address - Country:US
Practice Address - Phone:914-305-2730
Practice Address - Fax:914-305-2731
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174596-1207VX0201X
CT033383207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY77H691OtherEMPIRE BCBS
NY01398801Medicaid
NY77H691OtherEMPIRE BCBS
NY77H691OtherEMPIRE BCBS