Provider Demographics
NPI:1790225316
Name:TURTZ, JOHN STUART (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STUART
Last Name:TURTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1937
Mailing Address - Country:US
Mailing Address - Phone:914-834-5426
Mailing Address - Fax:
Practice Address - Street 1:28 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-1937
Practice Address - Country:US
Practice Address - Phone:914-834-5426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009473 - 1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist