Provider Information for 1225631542
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SAMUEL NELSON LCSW
Sex: Male
NPI: 1225631542
Last Updated: 2020-11-19
Certification Date: 2020-11-18
Certification Date: 2020-11-18
Details
| Name | Value | ||||||||
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| NPI | 1225631542 | ||||||||
| Enumeration Date | 2020-11-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 56 DRAKE LN MANHASSET, NY 11030-1228 United States Phone: 347-502-2849 | Fax: | ||||||||
| Primary Practice Address | 18 KAF-BET YALDEI MAALOT SAFED, SAFED 1323200 Israel Phone: 050-430-5140 | Fax: | ||||||||
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