Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 005276 | NY |
N | 103TS0200X | School Psychologist | 2183213 | NY |
NPI | 1073757746 |
---|---|
Provider Name | Mr. Mayer Chemtob |
First Address | Brooklyn, NY 11230 |
Second Address | Brooklyn, NY 11230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2009 |
Last Update Date | 13/06/2018 |