Provider Demographics
NPI:1497456701
Name:GETTENBERG, ARIELLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ARIELLA
Middle Name:
Last Name:GETTENBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 CENTRAL AVE APT 317
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2205
Mailing Address - Country:US
Mailing Address - Phone:516-640-6078
Mailing Address - Fax:
Practice Address - Street 1:623 CENTRAL AVE APT 317
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2205
Practice Address - Country:US
Practice Address - Phone:516-640-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty