Provider Demographics
NPI:1750263935
Name:GIDALOWITZ, BEN MOSHE
Entity type:Individual
Prefix:MR
First Name:BEN
Middle Name:MOSHE
Last Name:GIDALOWITZ
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 1:54 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2607
Mailing Address - Country:US
Mailing Address - Phone:917-618-4263
Mailing Address - Fax:
Practice Address - Street 1:4302 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1831
Practice Address - Country:US
Practice Address - Phone:718-686-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician