Provider Demographics
NPI:1831775337
Name:TARSHISH, CHAIM YACOV (PHD)
Entity type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:YACOV
Last Name:TARSHISH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OCEAN PKWY APT C23
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1522
Mailing Address - Country:US
Mailing Address - Phone:917-669-3647
Mailing Address - Fax:
Practice Address - Street 1:16 OCEAN PKWY APT C23
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1522
Practice Address - Country:US
Practice Address - Phone:917-669-3647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024159-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist