Provider Demographics
NPI:1659691343
Name:LIVNEY, DAN GARTENBERG (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:GARTENBERG
Last Name:LIVNEY
Suffix:
Gender:M
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:PO BOX 199
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-0199
Mailing Address - Country:US
Mailing Address - Phone:484-534-8830
Mailing Address - Fax:
Practice Address - Street 1:1958 BUTLER PIKE
Practice Address - Street 2:SUITE 418
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1285
Practice Address - Country:US
Practice Address - Phone:484-534-8830
Practice Address - Fax:844-601-5942
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017301103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist