Provider Demographics
NPI:1730437443
Name:JANSSEN, YVETTE GOERTZ (MD)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:GOERTZ
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WEST 69TH STREET
Mailing Address - Street 2:3B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4731
Mailing Address - Country:US
Mailing Address - Phone:212-874-0649
Mailing Address - Fax:
Practice Address - Street 1:47 WEST 69TH STREET
Practice Address - Street 2:3B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4731
Practice Address - Country:US
Practice Address - Phone:212-874-0649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1272342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry