Provider Demographics
NPI:1588032601
Name:SOLTZ, GAL
Entity Type:Individual
Prefix:
First Name:GAL
Middle Name:
Last Name:SOLTZ
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 1:379 3RD AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9028
Mailing Address - Country:US
Mailing Address - Phone:646-831-4646
Mailing Address - Fax:
Practice Address - Street 1:379 3RD AVE APT 3E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9028
Practice Address - Country:US
Practice Address - Phone:646-831-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021356103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical