Healthcare Provider Details

I. General information

NPI: 1184007437
Provider Name (Legal Business Name): NECHAMA GEWIRTZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 09/14/2025
Certification Date: 09/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2037 GLORIETA LN
LAS VEGAS NV
89134-6234
US

IV. Provider business mailing address

2037 GLORIETA LN
LAS VEGAS NV
89134-6234
US

V. Phone/Fax

Practice location:
  • Phone: 845-664-1781
  • Fax:
Mailing address:
  • Phone: 845-664-1781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA0726
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: