1841385655 NPI number — SETH GARTENLAUB D.C.

Table of content: SETH GARTENLAUB D.C. (NPI 1841385655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841385655 NPI number — SETH GARTENLAUB D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARTENLAUB
Provider First Name:
SETH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841385655
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 BOND ST
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
GREAT NECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11021-2418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-466-4900
Provider Business Mailing Address Fax Number:
516-466-4901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 BOND ST
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
GREAT NECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11021-2418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-466-4900
Provider Business Practice Location Address Fax Number:
516-466-4901
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  X009022 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02276277 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5898516 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1244581 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7680231 . This is a "ATENA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9170353 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1029940 . This is a "ASN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: C09022-7B . This is a "WORKERS COMPENSATION BOAR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P-11195476 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: X8H65 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2018345 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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