MEDICARE: MRS. KATERYNA ELIYAHU LSW

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	1041C0700X	Clinical Social Worker	128525	NY
2	1041C0700X	Clinical Social Worker	44SL07387600	NJ

General Provider Information

NPI Number	:	1598620130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATERYNA ELIYAHU LSW

Provider Business Mailing Address
First Line	:	138 SUSAN DR
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-1141
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 SUSAN DR
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-1141
Country	:	US
Telephone Number	:	516-582-3913
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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