Physician Compare National (NPI:1013069145)

HEALTHCARE PROVIDER: AVIVA ANTHEA GITLIN PSY.D

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1013069145
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214111640
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110411000079
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GITLIN
	Individual professional last name
Provider First Name	AVIVA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	34 S BROADWAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 110
	Group Practice or individual's line 2 address
City	WHITE PLAINS
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	106014432
	Group Practice or individual's zip code (9 digits when available)
Phone Number	91499707321
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y