Active NPI
Eliezer Shlomovich, LCSW-R
- Clinical Social Worker
- Douglaston, NY
National Provider Identifier
1881774578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 075902-1
- Practice address
- 24302 Northern Blvd
Douglaston, NY 11362-1150 - Phone
- (718) 423-6200
- NPI assigned
- Oct 17, 2006
- Last updated
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 075902-1 | NY | Primary |
| Clinical Social Worker | 1041C0700X | 065049 | NY |
Addresses
Primary practice location
24302 Northern Blvd
Douglaston, NY 11362-1150
Mailing address
1719 E 34 St.
Brooklyn, NY 11234
Phone (646) 262-9951
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 075902-1 | NY | MD | Social Worker |
| 065049 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497312000000",
"number": "1881774578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 E 34 ST.",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11234",
"telephone_number": "646-262-9951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24302 NORTHERN BLVD",
"city": "DOUGLASTON",
"state": "NY",
"postal_code": "113621150",
"telephone_number": "718-423-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHLOMOVICH",
"first_name": "ELIEZER",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2017-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "075902-1",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "065049",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglaston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.