Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2995 | OH |
NPI | 1245292127 |
---|---|
Provider Name | Dr. Kenneth Gerstenhaber |
First Address | Lyndhurst, OH 44124-2688 |
Second Address | Lyndhurst, OH 44124-2688 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 04/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0444497 | (05) | OH |
R1152 | (02) | OH |