Healthcare Provider Details

I. General information

NPI: 1154685071
Provider Name (Legal Business Name): ESTHER MINDY DEUTSCH MS SPECIAL ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 38TH ST
BROOKLYN NY
11218-3612
US

IV. Provider business mailing address

4102 13TH AVE APT 5B
BROOKLYN NY
11219-1392
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-3700
  • Fax:
Mailing address:
  • Phone: 917-474-4736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number559375111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: