Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 014281-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 014281-1 | NY |
NPI | 1013069145 |
---|---|
Provider Name | Dr. Aviva Anthea Gitlin |
First Address | White Plains, NY 10606-2810 |
Second Address | White Plains, NY 10601-4400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |