Healthcare Provider Details

I. General information

NPI: 1003753997
Provider Name (Legal Business Name): MILESTONE APPLIED BEHAVIOR ANALYSIS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 16TH AVE
BROOKLYN NY
11204-1806
US

IV. Provider business mailing address

5510 16TH AVE
BROOKLYN NY
11204-1806
US

V. Phone/Fax

Practice location:
  • Phone: 917-676-7251
  • 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: MOSHE A WALDMAN
Title or Position: OWNER
Credential:
Phone: 917-676-7251