Provider Demographics
NPI:1447017157
Name:BIELER, SHMUEL YITZCHAK (MPHNP-BC)
Entity type:Individual
Prefix:MR
First Name:SHMUEL
Middle Name:YITZCHAK
Last Name:BIELER
Suffix:
Gender:M
Credentials:MPHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MAGNOLIA RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2745
Mailing Address - Country:US
Mailing Address - Phone:201-403-4206
Mailing Address - Fax:
Practice Address - Street 1:1133 MAGNOLIA RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2745
Practice Address - Country:US
Practice Address - Phone:201-403-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY405595363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health