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NPI Code Detail

MEDICARE: MR. ELI T. NEWCOMB M.ED., BCBA

MEDICARE: MR. ELI T. NEWCOMB M.ED., BCBA
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
1103K00000XBehavior Analyst1-11-8690VA

General Provider Information

NPI Number : 1447527148
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ELI T. NEWCOMB M.ED., BCBA
Provider Business Mailing Address
First Line : 1701 BYRD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3011
Country : US
Telephone Number : 804-612-1947
Fax Number : 804-612-1955
Provider Business Practice Location Address
First Line : 1701 BYRD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3011
Country : US
Telephone Number : 804-612-1947
Fax Number : 804-612-1955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2011
Last Update Date : 11/23/2011

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