Provider Demographics
NPI:1265027692
Name:LICHTMAN, YECHIEL
Entity Type:Individual
Prefix:
First Name:YECHIEL
Middle Name:
Last Name:LICHTMAN
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 1:4111 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5894
Mailing Address - Country:US
Mailing Address - Phone:718-875-6900
Mailing Address - Fax:
Practice Address - Street 1:4111 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5894
Practice Address - Country:US
Practice Address - Phone:718-875-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker