MEDICARE: CHAYA BREUER

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1356081053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAYA BREUER

Provider Business Mailing Address
First Line	:	143 WELLBROOK AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5142
Country	:	US
Telephone Number	:	134-733-7831
Fax Number	:

Provider Business Practice Location Address
First Line	:	143 WELLBROOK AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-5142
Country	:	US
Telephone Number	:	134-733-7831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	03/30/2022

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