Healthcare Provider Details

I. General information

NPI: 1023958063
Provider Name (Legal Business Name): SPECIALTY ABA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PUBLIC SQ STE 303
HAGERSTOWN MD
21740-8180
US

IV. Provider business mailing address

209 EMPIRE BLVD
BROOKLYN NY
11225-3402
US

V. Phone/Fax

Practice location:
  • Phone: 718-305-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MARK RABINOWITZ
Title or Position: MEMBER
Credential:
Phone: 718-305-6200