Healthcare Provider Details

I. General information

NPI: 1255667135
Provider Name (Legal Business Name): ESTHER ESCOVITZ M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2009
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7238 MAIN ST
FLUSHING NY
11367-2408
US

IV. Provider business mailing address

14437 75TH RD
FLUSHING NY
11367-2416
US

V. Phone/Fax

Practice location:
  • Phone: 917-446-4952
  • Fax:
Mailing address:
  • Phone: 917-446-4952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1933908
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: