Healthcare Provider Details

I. General information

NPI: 1588393466
Provider Name (Legal Business Name): VERONIA GHOBRIAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2906 S FALKENBURG RD
RIVERVIEW FL
33578-2554
US

IV. Provider business mailing address

46 WASHINGTON AVE STE 1
SUFFERN NY
10901-5608
US

V. Phone/Fax

Practice location:
  • Phone: 877-276-0626
  • Fax:
Mailing address:
  • Phone: 877-276-0626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90513
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-222173
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: