Gersten-Thornburg, Iris J.

Gersten-Thornburg, Iris J. is an sole proprietor health care provider with primary practice located at 6729 Myrtle Ave , Glendale NY 11385-7063. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gersten-Thornburg, Iris J. can be contacted via phone (718) 456-7001.

Contact Information

Primary practice address
6729 Myrtle Ave Glendale NY 11385-7063
Phone: (718) 456-7001
Fax: (718) 456-9470
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X RO24501-1 New York

Profile Details

NPI number 1366460495
LBN Legal business name Gersten-Thornburg, Iris J.
Credentials LCSW-R
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366460495 NPPES
New York MEDICAID 00244624

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