Provider Demographics
NPI:1376598466
Name:PESACH TIKVAH HOPE DEVELOPMENT INC
Entity Type:Organization
Organization Name:PESACH TIKVAH HOPE DEVELOPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BAS SHEVY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:718-875-6900
Mailing Address - Street 1:18 MIDDLETON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-5415
Mailing Address - Country:US
Mailing Address - Phone:718-875-6900
Mailing Address - Fax:718-875-3282
Practice Address - Street 1:18 MIDDLETON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5415
Practice Address - Country:US
Practice Address - Phone:718-875-6900
Practice Address - Fax:718-875-3282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7679100A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW14871Medicare ID - Type Unspecified
NY009863110Medicare ID - Type Unspecified