Healthcare Provider Details

I. General information

NPI: 1790557015
Provider Name (Legal Business Name): NEW PATTERNS VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10431 PATTERSON AVE # C21
HENRICO VA
23238-5101
US

IV. Provider business mailing address

25 ROBERT PITT DR STE 106
MONSEY NY
10952-3366
US

V. Phone/Fax

Practice location:
  • Phone: 786-706-7793
  • Fax:
Mailing address:
  • Phone: 845-709-0972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHOLOM SWIMER
Title or Position: CEO
Credential:
Phone: 786-706-7793