Provider Demographics
NPI:1962921999
Name:HERTZIG, ASHLEIGH
Entity type:Individual
Prefix:MS
First Name:ASHLEIGH
Middle Name:
Last Name:HERTZIG
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 1:1 CABRINI BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5437
Mailing Address - Country:US
Mailing Address - Phone:201-919-0838
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:201-919-0838
Practice Address - Fax:201-919-0838
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NY104425104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker