Individual
ANTHONY HARTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-6059
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
028159
NY
363A00000X
Physician Assistant
MA061113
PA
Other
Enumeration date
09/25/2019
Last updated
09/13/2023
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