| Organization Name: | E. SHOLOM INC. |
| NPI Number: | 1003171455 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ARLENE FLORES (SERVICE COORDINATOR) |
| Mailing Address: | 13411 Kew Gardens Rd Richmond Hill |
| State: | NY US |
| Postal Code: | 114181930 |
| Phone Number: | 7184410155 |
| Fax Number: | 7188504720 |
| NPI Enumeration Date: | 07/11/2012 |
| NPI Last Update Date: | 07/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |