Healthcare Provider Details

I. General information

NPI: 1578484739
Provider Name (Legal Business Name): HOUSE OF SHALOM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 AVENUE Y FL 1
BROOKLYN NY
11235-6101
US

IV. Provider business mailing address

603 AVENUE Y FL 1
BROOKLYN NY
11235-6101
US

V. Phone/Fax

Practice location:
  • Phone: 347-713-2248
  • Fax: 347-713-2248
Mailing address:
  • Phone: 347-713-2248
  • Fax: 347-713-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: VLADA SHVARTSER
Title or Position: THERAPIST
Credential: MSED, SPED
Phone: 347-713-2248