Provider Demographics
NPI:1972639375
Name:HARTZ, CINDI LOUISE
Entity type:Individual
Prefix:DR
First Name:CINDI
Middle Name:LOUISE
Last Name:HARTZ
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 1:1415 BOSTON POST ROAD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538
Mailing Address - Country:US
Mailing Address - Phone:914-833-1502
Mailing Address - Fax:914-833-3607
Practice Address - Street 1:1415 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538
Practice Address - Country:US
Practice Address - Phone:914-833-1502
Practice Address - Fax:914-833-3607
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1609232080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1C7407OtherHEALTHNET
NYWP697OtherOXFORD HEALTH PLANS
NY01E53OtherEMPIRE BLUE CROSS
NY802320OtherUNITED HEALTH CARE
NY54028NOtherCIGNA HEALTH CARE