Provider Demographics
NPI:1396496840
Name:ABERGEL, YOSEPH YITZCHOK
Entity type:Individual
Prefix:MR
First Name:YOSEPH
Middle Name:YITZCHOK
Last Name:ABERGEL
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 1:3727 CLARINTH RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-2403
Mailing Address - Country:US
Mailing Address - Phone:667-239-0324
Mailing Address - Fax:
Practice Address - Street 1:500 REDLAND CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3264
Practice Address - Country:US
Practice Address - Phone:443-738-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD43102670500Medicaid