Healthcare Provider Details

I. General information

NPI: 1366359630
Provider Name (Legal Business Name): MR. SHLOIME M HERMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5309 18TH AVE FL 5
BROOKLYN NY
11204-1523
US

IV. Provider business mailing address

1451 52ND ST APT B3
BROOKLYN NY
11219-3923
US

V. Phone/Fax

Practice location:
  • Phone: 917-624-7595
  • Fax:
Mailing address:
  • Phone: 917-624-7595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: