MEDICARE: BETSHEVA ROYTBURD MSW LP

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	101YP2500X	Professional Counselor	P141146	NY

General Provider Information

NPI Number	:	1912854704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETSHEVA ROYTBURD MSW LP

Provider Business Mailing Address
First Line	:	84 ELDRIDGE ST APT 7
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10002-5236
Country	:	US
Telephone Number	:	917-796-8965
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 PLAZA ST E STE P109
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-5047
Country	:	US
Telephone Number	:	646-490-1930
Fax Number	:	646-809-8580

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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