Healthcare Provider Details

I. General information

NPI: 1518413145
Provider Name (Legal Business Name): RIVKA LEAH ZAGER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RIVKA LEAH YAVNE M.A.

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MENOCKER RD
MONSEY NY
10952-4912
US

IV. Provider business mailing address

12 MENOCKER ROAD
MONSEY NY
10952
US

V. Phone/Fax

Practice location:
  • Phone: 845-659-6873
  • Fax:
Mailing address:
  • Phone: 845-659-6873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number3598137
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: