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NPI Code Detail

MEDICARE: DR. SHALOM AUGENBAUM LCSW

MEDICARE: DR. SHALOM AUGENBAUM LCSW
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
11041C0700XClinical Social Worker
21041C0700XClinical Social Worker44SC05606100NJ
31041C0700XClinical Social Worker083703NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1083703OTHERNYPROFESSIONAL LICENSE

General Provider Information

NPI Number : 1174860431
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHALOM AUGENBAUM LCSW
Provider Business Mailing Address
First Line : 1268 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5241
Country : US
Telephone Number : 718-382-0045
Fax Number :
Provider Business Practice Location Address
First Line : 1268 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5241
Country : US
Telephone Number : 718-382-0045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2013
Last Update Date : 11/22/2022

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