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General NPI Number Information
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NPI Number | 1659691343
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Entity Type | Individual
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Provider Name | DAN GARTENBERG LIVNEY PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 1958 BUTLER PIKE SUITE 418
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-1285
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Country | US
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Telephone | 484-534-8830
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Fax | 844-601-5942
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Provider Business Mailing Address
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Address Line | PO BOX 199
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-0199
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Country | US
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Telephone | 484-534-8830
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017301
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License Number State | PA
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