Provider Demographics
NPI:1720561061
Name:WERTENTHEIL, ATARA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ATARA
Middle Name:
Last Name:WERTENTHEIL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N VILLAGE AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3712
Mailing Address - Country:US
Mailing Address - Phone:516-274-7876
Mailing Address - Fax:
Practice Address - Street 1:100 N VILLAGE AVE STE 18
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3712
Practice Address - Country:US
Practice Address - Phone:917-748-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling