Provider Demographics
NPI:1073221701
Name:POSKLINSKY SHEHORY, HAMUTAL
Entity Type:Individual
Prefix:
First Name:HAMUTAL
Middle Name:
Last Name:POSKLINSKY SHEHORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 MONTGOMERY ST.
Mailing Address - Street 2:APT 1E
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302
Mailing Address - Country:US
Mailing Address - Phone:267-934-4791
Mailing Address - Fax:
Practice Address - Street 1:297 MONTGOMERY ST.
Practice Address - Street 2:APT 1E
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302
Practice Address - Country:US
Practice Address - Phone:267-934-4791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP118795101200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist