Healthcare Provider Details

I. General information

NPI: 1518837426
Provider Name (Legal Business Name): ADVANCE THERAPY ABA SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 E ROBINSON ROAD SUITE-285
AMHERST NY
14228
US

IV. Provider business mailing address

3840 E ROBINSON ROAD SUITE-285
AMHERST NY
14228
US

V. Phone/Fax

Practice location:
  • Phone: 646-298-1814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name: RAHUL MALHOTRA
Title or Position: VICE PRESIDE-OPERATIONS
Credential:
Phone: 647-323-6070