Healthcare Provider Details

I. General information

NPI: 1477945848
Provider Name (Legal Business Name): LEVI OBERLANDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MIDDLETON ST
BROOKLYN NY
11206-5415
US

IV. Provider business mailing address

18 MIDDLETON ST
BROOKLYN NY
11206-5415
US

V. Phone/Fax

Practice location:
  • Phone: 718-875-6900
  • Fax: 718-875-3282
Mailing address:
  • Phone: 718-875-6900
  • Fax: 718-875-3282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number096269
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: