MEDICARE: TIFFERET SHABAT MSED

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1528784691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFERET SHABAT MSED

Provider Business Mailing Address
First Line	:	2240 BURNETT ST APT 2K
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5854
Country	:	US
Telephone Number	:	347-701-8279
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 BURNETT ST APT 2K
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5854
Country	:	US
Telephone Number	:	347-701-8279
Fax Number	:

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

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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Directions to “ TIFFERET SHABAT MSED” Practice Location

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