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General NPI Number Information
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NPI Number | 1962547240
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Entity Type | Organization
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Legal Business Name | YAGOLD INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 775 WESTMINSTER RD
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City | BROOKLYN
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State | NY
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Zip | 11230-2401
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Country | US
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Telephone | 917-476-3723
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Fax |
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Provider Business Mailing Address
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Address Line | 775 WESTMINSTER RD
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City | BROOKLYN
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State | NY
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Zip | 11230-2401
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Country | US
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Telephone | 917-476-3723
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MASHA MIRIAM YAGLOM
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Credential | M.S.,L.C.S.W.
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Telephone | 917-476-3723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R045326-1
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License Number State | NY
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