Healthcare Provider Details

I. General information

NPI: 1396428777
Provider Name (Legal Business Name): ARYEH KUGEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 BEDFORD AVE
BROOKLYN NY
11205-3913
US

IV. Provider business mailing address

154 OAKVILLE ST
STATEN ISLAND NY
10314-5053
US

V. Phone/Fax

Practice location:
  • Phone: 718-875-6900
  • Fax:
Mailing address:
  • Phone: 201-466-6148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: