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General NPI Number Information
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NPI Number | 1982353769
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Entity Type | Organization
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Legal Business Name | CHAVRUSA MATCH
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 287 DIVISION AVE APT 3D
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City | BROOKLYN
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State | NY
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Zip | 11211-7326
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Country | US
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Telephone | 718-614-5317
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Fax |
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Provider Business Mailing Address
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Address Line | 287 DIVISION AVE APT 3D
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City | BROOKLYN
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State | NY
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Zip | 11211-7326
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Country | US
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Telephone | 718-614-5317
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMUEL GOLDSTEIN
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Credential | RABBI
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Telephone | 718-614-5317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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