Individual
CAROL C ERTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
799 BROADWAY, SUITE 631, NEW YORK, NY 10003-6811
(212) 979-6760
Mailing address
799 BROADWAY, SUITE 631, NEW YORK, NY 10003-6811
(212) 979-6760
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
R-045532
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P1091471
OXFORD
NY
Enumeration date
04/23/2007
Last updated
07/16/2007
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