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General NPI Number Information
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NPI Number | 1265746499
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Entity Type | Organization
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Legal Business Name | SHALOMAH MINISTRY INC
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 07/29/2010
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Provider Practice Location Address
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Address Line | 14427 175TH ST
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City | JAMAICA
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State | NY
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Zip | 11434-4813
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Country | US
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Telephone | 917-754-8513
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Fax |
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Provider Business Mailing Address
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Address Line | 11714 145TH ST
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City | JAMAICA
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State | NY
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Zip | 11436-1315
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Country | US
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Telephone | 917-754-8513
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. LOUISE PYANT
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Credential | PH.D
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Telephone | 917-754-8513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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