MEDICARE: BEHAVIOR EFFECTS APPLIED BEHAVIOR ANALYSIS SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1053266015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR EFFECTS APPLIED BEHAVIOR ANALYSIS SERVICES PLLC

Provider Business Mailing Address
First Line	:	72 SEAMAN AVE APT 1G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10034-2823
Country	:	US
Telephone Number	:
Fax Number	:	347-928-3338

Provider Business Practice Location Address
First Line	:	72 SEAMAN AVE APT 1G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10034-2823
Country	:	US
Telephone Number	:	347-928-3338
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. DANIEL SULLIVAN
Credential	:	BCBA, LBA
Telephone Number	:	347-928-3338

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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