Healthcare Provider Details

I. General information

NPI: 1699612937
Provider Name (Legal Business Name): TAYLOR NEGRON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 BEACH 69TH ST APT 6H
ARVERNE NY
11692-1378
US

IV. Provider business mailing address

190 BEACH 69TH ST APT 6H
ARVERNE NY
11692-1378
US

V. Phone/Fax

Practice location:
  • Phone: 516-849-2071
  • Fax: 516-849-2071
Mailing address:
  • Phone: 516-849-2071
  • Fax: 516-849-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00342000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: