Provider Demographics
NPI:1114533320
Name:GERSHONOWITZ, YOCHEVED
Entity Type:Individual
Prefix:
First Name:YOCHEVED
Middle Name:
Last Name:GERSHONOWITZ
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 1:1694 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2216
Mailing Address - Country:US
Mailing Address - Phone:917-968-1009
Mailing Address - Fax:
Practice Address - Street 1:1694 E 7TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2216
Practice Address - Country:US
Practice Address - Phone:917-968-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2022-11-28
Deactivation Date:2021-12-21
Deactivation Code:
Reactivation Date:2022-03-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst