Provider Demographics
NPI:1366965162
Name:NEUMAN, MORDECHAI
Entity type:Individual
Prefix:
First Name:MORDECHAI
Middle Name:
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-0964
Mailing Address - Country:US
Mailing Address - Phone:845-459-4512
Mailing Address - Fax:
Practice Address - Street 1:6 HOLLY CIR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2929
Practice Address - Country:US
Practice Address - Phone:845-459-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0953481041C0700X
NY087362-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical