Provider Demographics
NPI:1134158025
Name:POLITZER, GABOR
Entity type:Individual
Prefix:MR
First Name:GABOR
Middle Name:
Last Name:POLITZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 GARTH RD
Mailing Address - Street 2:#6C
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3755
Mailing Address - Country:US
Mailing Address - Phone:718-205-0664
Mailing Address - Fax:718-205-3330
Practice Address - Street 1:6370 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2831
Practice Address - Country:US
Practice Address - Phone:718-205-0664
Practice Address - Fax:718-205-3330
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02324716Medicaid