Provider Demographics
NPI:1902960834
Name:GARFINKLE, MARTIN I (INITIAL ONLY) (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:I (INITIAL ONLY)
Last Name:GARFINKLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 PRESIDENT ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4154
Mailing Address - Country:US
Mailing Address - Phone:718-370-3134
Mailing Address - Fax:718-982-7006
Practice Address - Street 1:55 PRESIDENT ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4154
Practice Address - Country:US
Practice Address - Phone:718-370-3134
Practice Address - Fax:718-982-7006
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO179361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical