| The Derech Shalom Center Inc | |
|
75 Montebello Rd Suffern NY 10901-3746 | |
| (845) 523-9300 | |
| Not Available |
| Full Name | The Derech Shalom Center Inc |
|---|---|
| Speciality | Case Management |
| Location | 75 Montebello Rd, Suffern, New York |
| Authorized Official Name and Position | Avi Kahan (FOUNDER AND PRESIDENT) |
| Authorized Official Contact | 8455239300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Derech Shalom Center Inc 75 Montebello Rd Suffern NY 10901-3746 Ph: (845) 523-9300 | The Derech Shalom Center Inc 75 Montebello Rd Suffern NY 10901-3746 Ph: (845) 523-9300 |
| NPI Number | 1477295848 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Medicare PECOS PAC ID | 5496114506 |
|---|---|
| Medicare Enrollment ID | O20230707002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477295848 | NPI | - | NPPES |
| Provider Name | Shira Andrusier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144833765 PECOS PAC ID: 7911315502 Enrollment ID: I20210420002239 |
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