Healthcare Provider Details

I. General information

NPI: 1154248870
Provider Name (Legal Business Name): EVE ELBOGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHAVA GOBIOFF MHC

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211A BEACH 11TH ST
FAR ROCKAWAY NY
11691-5578
US

IV. Provider business mailing address

211A BEACH 11TH ST
FAR ROCKAWAY NY
11691-5578
US

V. Phone/Fax

Practice location:
  • Phone: 917-696-1942
  • Fax:
Mailing address:
  • Phone: 917-696-1942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: