Provider Demographics
NPI:1508507997
Name:ISRAEL, ARI MELECH
Entity Type:Individual
Prefix:MR
First Name:ARI
Middle Name:MELECH
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:GRANT
Other - Middle Name:MICHAEL
Other - Last Name:ZITOMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3863
Mailing Address - Country:US
Mailing Address - Phone:781-350-4430
Mailing Address - Fax:
Practice Address - Street 1:42 HIGH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3863
Practice Address - Country:US
Practice Address - Phone:617-312-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health