Provider Demographics
NPI:1790106953
Name:ETTINGER, ARIELLE B (DPT)
Entity Type:Individual
Prefix:DR
First Name:ARIELLE
Middle Name:B
Last Name:ETTINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:ARIELLE
Other - Middle Name:B
Other - Last Name:GLADOWSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:36 W. 44TH STREET
Mailing Address - Street 2:SUITE 403
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-759-2280
Mailing Address - Fax:212-938-0015
Practice Address - Street 1:36 W 44TH ST
Practice Address - Street 2:SUITE 403
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8102
Practice Address - Country:US
Practice Address - Phone:212-759-2280
Practice Address - Fax:212-938-0015
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist