MEDICARE: CHAVERIM ENTERPRISES

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	252Y00000X	Early Intervention Provider Agency	015115-1	NY

General Provider Information

NPI Number	:	1518103183
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAVERIM ENTERPRISES

Provider Business Mailing Address
First Line	:	14 KINGSTON DR
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1206
Country	:	US
Telephone Number	:	845-354-1112
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 KINGSTON DR
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1206
Country	:	US
Telephone Number	:	845-354-1112
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. CHANA B SHAPIRO
Credential	:
Telephone Number	:	845-354-1112

Provider Enumeration Date	:	01/01/2009
Last Update Date	:	01/01/2009

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Directions to “CHAVERIM ENTERPRISES ” Practice Location

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