Provider Demographics
NPI:1780017582
Name:GOTTESMAN, ESTHER (MS)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:
Last Name:GOTTESMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMASPIK WAY
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-8452
Mailing Address - Country:US
Mailing Address - Phone:845-352-6213
Mailing Address - Fax:
Practice Address - Street 1:1 HAMASPIK WAY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-8452
Practice Address - Country:US
Practice Address - Phone:845-352-6213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2355936174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist