NEW YORK (AP) – Rabbi Moses Teitelbaum, worldwide spiritual leader of tens of thousands of Satmar Hassidim with the largest congregations centered in the United States, died Monday. He was 91.

Teitelbaum, the rebbe, or grand rabbi, of the ultra-Orthodox Jewish sect since 1980, died at Mount Sinai Hospital, said community leader Isaac Abraham. He entered the hospital on March 30 and was being treated for spinal cancer and other ailments.

The group has some 120,000 followers worldwide, according to sociologist Samuel Heilman, with large congregations in Brooklyn’s Williamsburg neighborhood and the village of Kiryas Joel, 45 miles northwest of New York City in Orange County.

Teitelbaum was born in Siget, in present-day Romania. He escaped Nazi persecution during World War II and came to the United States in 1946. Teitelbaum took over leadership of the Satmar sect from his uncle, Rabbi Joel Teitelbaum, who died childless in 1979 at age 93. He took the formal title of rebbe the following year.

The question of who will succeed the rebbe as spiritual leader looms high. Two of his sons, Aaron and Zalmen Teitelbaum, have been feuding over that question.

In 2004, a judge in Brooklyn refused to rule in the sons’ dispute over the heir to the Satmar sect, saying the matter was for the grand rabbi to decide.

Teitelbaum had tabbed Zalmen Teitelbaum to run the Williamsburg congregation and Aaron to take over Kiryas Joel, but on the larger question of which one should prevail, the grand rabbi remained silent.

“There’s a conflict as to who will be the major head,” said Heilman, a professor of sociology at Queens College who studies Orthodox Jewish sects. “Not a lot will be changed. As to who will be the dominant one, it will shake out in time.”

Ultimately, a will may resolve the dispute, Heilman said.

“There may be a will. The rebbe has been too ill to provide an unequivocal answer to that, or maybe he didn’t want to while he was alive,” he said. In addition to a traditional will, Heilman said, Teitelbaum may have left “a moral will” that could leave his disciples a message or hint at who should be the primary leader.

The professor suggested that in the end there may be more than one leader, which he said would not be unprecedented among Jewish sects.

The Satmar Hasidic sect has between 65,000 to 75,000 disciples in the United States – 95 percent of whom live in New York state – and about 120,000 worldwide, including Canada and a small number in Israel, said Heilman.

The issue of Teitelbaum’s successor is highly charged and sensitive because the job of a grand rabbi is that of “an intermediary between his followers and God,” said Heilman. “He is a father to thousands of people.”

The rebbe gives advice not only “on political matters, but very much on domestic issues. Followers come to him with all sorts of questions, which range from ‘who should I marry, should I undergo this particular surgery,’ anything that’s important in a Hasid’s life, they will check with the rebbe,” Heilman said.

“His blessings carry enormous spiritual and moral value. That’s why the quest for who has the charisma, a combination of office and blood” is so important to Satmars, the professor added.

The grand rabbi also presides over the sect’s schools, camps, a matzo factory and loan company.

The Satmars are not the only Jewish sect to struggle over the selection of a successor. The Lubavitcher Hassidim have been without a leader since the death in 1994 of its grand rabbi, Menachem Mendel Schneerson, who left no children and did not designate a new rebbe. And the death last year of the head of the Bobov Hassidim touched off a battle for succession between his half-brother and a son-in-law.

Joel Teitelbaum, Moses Teitelbaum’s uncle, was imprisoned in Nazi concentration camps during World War II before escaping to Israel and eventually settling in Brooklyn and Kiryas Joel – named “Village of Joel” in his honor – after the war.

The village was incorporated in 1977 and became the center of a legal battle over separation of church and state when lawmakers sought to create a public school district to provide special education programs.

The Supreme Court ruled in 1994 that the state had unlawfully singled out a particular religious group for special treatment. Further efforts by New York legislators to create a school district within the village also were struck down.

Teitelbaum is survived by four sons, two daughters and dozens of grandchildren.

The group has some 120,000 followers worldwide, according to sociologist Samuel Heilman, with large congregations in Brooklyn’s Williamsburg neighborhood and the village of Kiryas Joel, 45 miles northwest of New York City in Orange County. The village was the center of a landmark court fight in the 1990s over state officials’ efforts to provide school aid there.

The Satmars emphasize tradition and adhere to a strict dress code – long skirts for women, long black coats, black hats and long beards for men. Marriages are arranged and married women must keep their heads covered. The sect takes its name from the town of Satu Mare in what is now Romania.

Sect followers are so single-minded in their devotion to tradition they even oppose the state of Israel, because they believe that biblically, Jewish sovereignty over the ancient Land of Israel can come only with the Messiah.

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Associated Press writer Elizabeth LeSure contributed to this report.

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