MEDICARE: ATERET AVOTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1033470752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATERET AVOTH LLC

Provider Business Mailing Address
First Line	:	1410 E 10TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6504
Country	:	US
Telephone Number	:	718-998-5400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 E 10TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6504
Country	:	US
Telephone Number	:	718-998-5400
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RIVKIE SCHARF
Credential	:
Telephone Number	:	718-998-5400

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	05/30/2012

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Directions to “ATERET AVOTH LLC ” Practice Location

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