Healthcare Provider Details

I. General information

NPI: 1093324733
Provider Name (Legal Business Name): ELISHEVA SARAH BELLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/21/2022
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

YEHOSHAFAT 4 APT 5
JERUSALEM ISRAEL
9315204
IL

IV. Provider business mailing address

YEHOSHAFAT 4 APT 5
JERUSALEM ISRAEL
9315204
IL

V. Phone/Fax

Practice location:
  • Phone: 201-906-7259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number023446
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: