Provider Demographics
NPI:1881298958
Name:CONGREGATION VEHAREV
Entity type:Organization
Organization Name:CONGREGATION VEHAREV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEACHER OF SWD
Authorized Official - Prefix:
Authorized Official - First Name:SUSSMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-783-1523
Mailing Address - Street 1:34 S 9TH ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-6118
Mailing Address - Country:US
Mailing Address - Phone:718-783-1523
Mailing Address - Fax:
Practice Address - Street 1:34 S 9TH ST APT 6A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-6118
Practice Address - Country:US
Practice Address - Phone:718-783-1523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVV86563AMedicaid