Provider Demographics
NPI:1083332662
Name:YERUSHALMI SEGEV, NOAA
Entity Type:Individual
Prefix:
First Name:NOAA
Middle Name:
Last Name:YERUSHALMI SEGEV
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 1:400 W 63RD ST APT 1902
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0450
Mailing Address - Country:US
Mailing Address - Phone:929-248-2834
Mailing Address - Fax:
Practice Address - Street 1:400 W 63RD ST APT 1902
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10069-0450
Practice Address - Country:US
Practice Address - Phone:929-248-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker