Provider Demographics
NPI:1013492677
Name:GORNSTEIN, MARLA J
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:J
Last Name:GORNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GULLANE DR
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9287
Mailing Address - Country:US
Mailing Address - Phone:518-439-3737
Mailing Address - Fax:
Practice Address - Street 1:5 GULLANE DR
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9287
Practice Address - Country:US
Practice Address - Phone:518-439-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical