Provider Demographics
NPI:1740992635
Name:PEER TIROSH, RIVI
Entity type:Individual
Prefix:
First Name:RIVI
Middle Name:
Last Name:PEER TIROSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WARREN ST APT 3160
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1375
Mailing Address - Country:US
Mailing Address - Phone:914-415-9974
Mailing Address - Fax:
Practice Address - Street 1:194 NASSAU AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5362
Practice Address - Country:US
Practice Address - Phone:718-701-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111406-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY111406-01OtherLMSW LICENSE NUMBER