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General NPI Number Information
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NPI Number | 1407089980
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Entity Type | Organization
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Legal Business Name | GRISELDA M.BARTHA
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 4610 61ST ST H
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City | WOODSIDE
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State | NY
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Zip | 11377-5766
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Country | US
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Telephone | 347-420-8295
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Fax |
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Provider Business Mailing Address
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Address Line | 222 BEACH 122 STR
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City | BELLE HARBOR
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State | NY
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Zip | 11694
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. GRISELDA MABEL BARTHA
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Credential | M.D.
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Telephone | 347-420-8295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 215392
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License Number State | NY
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