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NPI Code Detail

MEDICARE: TAJH DEWITT

MEDICARE: TAJH DEWITT
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1457129710
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAJH DEWITT
Provider Business Mailing Address
First Line : 83 WOODBINE ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11221-4944
Country : US
Telephone Number : 646-780-9050
Fax Number :
Provider Business Practice Location Address
First Line : 83 WOODBINE ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11221-4944
Country : US
Telephone Number : 646-780-9050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2023
Last Update Date : 03/05/2025

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Directions to “ TAJH DEWITT ” Practice Location

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