Provider Demographics
NPI:1669229456
Name:BARTLEY, JANET N
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:N
Last Name:BARTLEY
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 1:11019 213TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1815
Mailing Address - Country:US
Mailing Address - Phone:718-513-8577
Mailing Address - Fax:
Practice Address - Street 1:10450 102ND ST APT 2E
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-2204
Practice Address - Country:US
Practice Address - Phone:929-354-1829
Practice Address - Fax:929-244-7394
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1134100171106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician