Individual
CHARLES GEWIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3000
Mailing address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
022405
NY
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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