Healthcare Provider Details

I. General information

NPI: 1033781414
Provider Name (Legal Business Name): MENACHEM RIMLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 EASTERN PKWY
BROOKLYN NY
11213-3310
US

IV. Provider business mailing address

763 EASTERN PKWY APT F20
BROOKLYN NY
11213-3457
US

V. Phone/Fax

Practice location:
  • Phone: 718-774-5050
  • Fax:
Mailing address:
  • Phone: 646-737-8313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP110251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: