=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306526744
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TALMUD TORAH CHAYEI OLAM
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2023
-----------------------------------------------------
Last Update Date | 07/20/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7 KILE CT STE 25
-----------------------------------------------------
City | AIRMONT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10952-4531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-250-8363
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 25 ROBERT PITT DR
-----------------------------------------------------
City | MONSEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10952-3365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-250-8363
-----------------------------------------------------
Fax | 845-250-8364
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TRUSTEE
-----------------------------------------------------
Name | SHLOME EKSTEIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-760-3144
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------