Healthcare Provider Details

I. General information

NPI: 1205031341
Provider Name (Legal Business Name): PAUL GELTNER D.S.W., L.C.S.W
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 8TH ST.
BROOKLYN NY
11215
US

IV. Provider business mailing address

301 8TH ST.
BROOKLYN NY
11215
US

V. Phone/Fax

Practice location:
  • Phone: 212-229-0692
  • Fax: 718-768-5910
Mailing address:
  • Phone: 212-229-0692
  • Fax: 718-768-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPR028083-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: