Provider Demographics
NPI:1063592970
Name:HARTENECK, PATRICIA (PHD)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:HARTENECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 EAST 94TH ST.
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:212-939-7200
Mailing Address - Fax:212-939-7201
Practice Address - Street 1:207 EAST 94TH ST.
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:212-939-7200
Practice Address - Fax:212-939-7201
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018428-1103TC0700X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist