MEDICARE: YISROEL SHLOMO TAUB FNP

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	163WE0003X	Emergency Registered Nurse	756353	NY
2	363LF0000X	Family Nurse Practitioner	351102	NY
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	408017	NY

General Provider Information

NPI Number	:	1609578756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YISROEL SHLOMO TAUB FNP

Provider Business Mailing Address
First Line	:	1204 E 34TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4139
Country	:	US
Telephone Number	:	929-688-2995
Fax Number	:

Provider Business Practice Location Address
First Line	:	4406 12TH AVE APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2077
Country	:	US
Telephone Number	:	718-438-4400
Fax Number	:

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

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	02/04/2026

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