Provider Demographics
NPI:1255826293
Name:MEISELS, MOSHE
Entity Type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:MEISELS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 LORIMER ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-8050
Mailing Address - Country:US
Mailing Address - Phone:917-821-3090
Mailing Address - Fax:
Practice Address - Street 1:57 LORIMER ST APT 4C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-8050
Practice Address - Country:US
Practice Address - Phone:917-821-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP08419103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst