Provider Demographics
NPI:1518202191
Name:GARTENBERG, MALKI AMY
Entity Type:Individual
Prefix:
First Name:MALKI
Middle Name:AMY
Last Name:GARTENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 VILLA LN
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1020
Mailing Address - Country:US
Mailing Address - Phone:845-270-0978
Mailing Address - Fax:
Practice Address - Street 1:8 VILLA LN
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1020
Practice Address - Country:US
Practice Address - Phone:845-270-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health