Provider Demographics
NPI:1265222905
Name:GUREWICZ, MENUCHA ROCHEL
Entity type:Individual
Prefix:
First Name:MENUCHA
Middle Name:ROCHEL
Last Name:GUREWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-7220
Mailing Address - Country:US
Mailing Address - Phone:773-414-4741
Mailing Address - Fax:
Practice Address - Street 1:5007 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-7220
Practice Address - Country:US
Practice Address - Phone:773-414-4741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG620556069210106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician