Provider Demographics
NPI:1679985402
Name:GARTENHAUS, MICHAEL I (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:I
Last Name:GARTENHAUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8931 161ST ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-6140
Mailing Address - Country:US
Mailing Address - Phone:718-291-6161
Mailing Address - Fax:718-526-6169
Practice Address - Street 1:8931 161ST ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6140
Practice Address - Country:US
Practice Address - Phone:718-291-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006819213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery