MEDICARE: MISS CHAYA GOLDA LOBEL MS, ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	735626121	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	735626121	OTHER	NY	MASTERS IN SPECIAL EDUCATION

General Provider Information

NPI Number	:	1093141541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHAYA GOLDA LOBEL MS, ED

Provider Business Mailing Address
First Line	:	2718 AVENUE I
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2929
Country	:	US
Telephone Number	:	347-782-4649
Fax Number	:	718-252-0623

Provider Business Practice Location Address
First Line	:	2718 AVENUE I
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2929
Country	:	US
Telephone Number	:	347-782-4649
Fax Number	:	718-252-0623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2013
Last Update Date	:	09/16/2013

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