Provider Demographics
NPI:1861136384
Name:ALZUBER, ESMAHAN B
Entity type:Individual
Prefix:
First Name:ESMAHAN
Middle Name:B
Last Name:ALZUBER
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 1:376 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-1806
Mailing Address - Country:US
Mailing Address - Phone:347-313-5260
Mailing Address - Fax:
Practice Address - Street 1:376 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-1806
Practice Address - Country:US
Practice Address - Phone:347-313-5260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJLJ724444646OtherEMPIRE B.C.B.S
NYMB30622KMedicaid