MEDICARE: CHAYA MERMERSTEIN

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	1041C0700X	Clinical Social Worker	030366	NY

General Provider Information

NPI Number	:	1578351763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAYA MERMERSTEIN

Provider Business Mailing Address
First Line	:	1544 OCEAN PKWY APT 5B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7090
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1544 OCEAN PKWY APT 5B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7090
Country	:	US
Telephone Number	:	917-860-6266
Fax Number	:

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

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	04/28/2025

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