Provider Demographics
NPI:1932669173
Name:HERSKOVICS, YEDIDYAH SINAI (LMSW)
Entity Type:Individual
Prefix:
First Name:YEDIDYAH
Middle Name:SINAI
Last Name:HERSKOVICS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 4TH AVE # 220
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7006
Mailing Address - Country:US
Mailing Address - Phone:718-238-6444
Mailing Address - Fax:
Practice Address - Street 1:9201 4TH AVE # 220
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7006
Practice Address - Country:US
Practice Address - Phone:718-238-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104606104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker