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NPI Code Detail

MEDICARE: MS. KEILANY ASHLEY BALBUENA SANTANA

MEDICARE: MS. KEILANY ASHLEY BALBUENA SANTANA
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 Analyst

General Provider Information

NPI Number : 1710608583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KEILANY ASHLEY BALBUENA SANTANA
Provider Business Mailing Address
First Line : 463 7TH AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10018-7448
Country : US
Telephone Number : 212-582-9100
Fax Number :
Provider Business Practice Location Address
First Line : 463 7TH AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10018-7448
Country : US
Telephone Number : 212-582-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2022
Last Update Date : 09/08/2022

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Directions to “ MS. KEILANY ASHLEY BALBUENA SANTANA ” Practice Location

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