MEDICARE: MR. MORDECHAI TZVI MEISELS M.S.

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	174400000X	Specialist		NY
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1447514666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MORDECHAI TZVI MEISELS M.S.

Provider Business Mailing Address
First Line	:	1667 42ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-1477
Country	:	US
Telephone Number	:	347-743-7013
Fax Number	:

Provider Business Practice Location Address
First Line	:	1338 44TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2108
Country	:	US
Telephone Number	:	718-304-9977
Fax Number	:

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

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	06/07/2022

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