Provider Demographics
NPI:1780085613
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:845-471-8175
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:845-471-8175
Mailing Address - Fax:845-471-0139
Practice Address - Street 1:1 GLEN BROOK CT
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1832
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:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006984103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000877Medicare PIN
NYA40008115Medicare UPIN