Provider Demographics
NPI:1922249325
Name:WILLIAM H. HARTWIG, PH.D., P.C.
Entity Type:Organization
Organization Name:WILLIAM H. HARTWIG, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:HARTWIG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-297-6618
Mailing Address - Street 1:1 GLEN BROOK CT
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-1832
Mailing Address - Country:US
Mailing Address - Phone:845-297-6618
Mailing Address - Fax:845-471-0139
Practice Address - Street 1:12 DAVIS AVENUE
Practice Address - Street 2:VASSAR PROFESSIONAL BUILDING 2 N
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2408
Practice Address - Country:US
Practice Address - Phone:845-471-8175
Practice Address - Fax:845-471-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006984103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA40008115Medicare PIN
NYA100000877Medicare PIN