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NPI Code Detail

MEDICARE: DAVAA ULZII

MEDICARE: DAVAA ULZII
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 Analyst1-14-16331CT
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1881094761
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVAA ULZII
Provider Business Mailing Address
First Line : 75 GEORGE WASHINGTON TPKE
Second Line :
City : BURLINGTON
State : CT
Zip : 06013-2413
Country : US
Telephone Number : 860-805-3288
Fax Number :
Provider Business Practice Location Address
First Line : 835 BLOOMFIELD AVE
Second Line :
City : WINDSOR
State : CT
Zip : 06095-2363
Country : US
Telephone Number : 860-805-3288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2014
Last Update Date : 05/08/2023

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Directions to “ DAVAA ULZII ” Practice Location

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