Provider Demographics
NPI:1518376268
Name:HANOVER, ELISHEVA YEHUDIT (MSW)
Entity Type:Individual
Prefix:
First Name:ELISHEVA
Middle Name:YEHUDIT
Last Name:HANOVER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-1620
Mailing Address - Country:US
Mailing Address - Phone:410-258-1217
Mailing Address - Fax:
Practice Address - Street 1:34 MURRAY ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-1920
Practice Address - Country:US
Practice Address - Phone:203-756-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker