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General NPI Number Information
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NPI Number | 1295095883
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Entity Type | Organization
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Legal Business Name | GARTENBERG FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 8575 E PRINCESS DR SUITE # 107
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-5483
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Country | US
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Telephone | 602-363-1631
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Fax | 888-360-8644
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Provider Business Mailing Address
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Address Line | 16211 N SCOTTSDALE RD SUITE A6A-213
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1584
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Country | US
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Telephone | 602-363-1631
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Fax | 888-360-8644
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELISSA B. GARTENBERG
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Credential | D.O.
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Telephone | 602-363-1631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4155
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License Number State | AZ
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