Provider Demographics
NPI:1063747087
Name:BARTULA, DAGMARA
Entity type:Individual
Prefix:
First Name:DAGMARA
Middle Name:
Last Name:BARTULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3627
Mailing Address - Country:US
Mailing Address - Phone:718-290-2410
Mailing Address - Fax:718-856-6867
Practice Address - Street 1:198 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3627
Practice Address - Country:US
Practice Address - Phone:718-290-2410
Practice Address - Fax:718-856-6867
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health