Provider Demographics
NPI:1144452673
Name:HERTZ ZILBERBERG, ANDREA J (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:J
Last Name:HERTZ ZILBERBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 LEROY AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1426
Mailing Address - Country:US
Mailing Address - Phone:516-812-8335
Mailing Address - Fax:
Practice Address - Street 1:141 WASHINGTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1669
Practice Address - Country:US
Practice Address - Phone:917-693-1654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP54459103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical