Healthcare Provider Details

I. General information

NPI: 1073958112
Provider Name (Legal Business Name): ALIZA ESTHER GARDENSWARTZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

16 HIGHGATE TER
BERGENFIELD NJ
07621-3920
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7997
  • Fax:
Mailing address:
  • Phone: 551-404-8826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number284247
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: