Provider Demographics
NPI:1114295870
Name:SIFF, SHOSHANA MALKA
Entity Type:Individual
Prefix:MRS
First Name:SHOSHANA
Middle Name:MALKA
Last Name:SIFF
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 1:463 READS LN
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5430
Mailing Address - Country:US
Mailing Address - Phone:718-868-1086
Mailing Address - Fax:
Practice Address - Street 1:463 READS LN
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5430
Practice Address - Country:US
Practice Address - Phone:718-868-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst