Provider Demographics
NPI:1609848605
Name:GERTZ, MARIA EMILIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:EMILIA
Last Name:GERTZ
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 1:315 W 103RD ST
Mailing Address - Street 2:2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4485
Mailing Address - Country:US
Mailing Address - Phone:646-209-4747
Mailing Address - Fax:
Practice Address - Street 1:50 LEXINGTON AVE
Practice Address - Street 2:LLC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2935
Practice Address - Country:US
Practice Address - Phone:646-209-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016276103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical