Healthcare Provider Details

I. General information

NPI: 1932917564
Provider Name (Legal Business Name): CASSIDY GELTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W 86TH ST
NEW YORK NY
10024-4018
US

IV. Provider business mailing address

144 HUNTINGTON ST APT 3
BROOKLYN NY
11231-0847
US

V. Phone/Fax

Practice location:
  • Phone: 212-362-8755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number124720
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: