Healthcare Provider Details

I. General information

NPI: 1942132790
Provider Name (Legal Business Name): GOLDEN HARTZ ABA VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1273 46TH ST STE 106
BROOKLYN NY
11219-2027
US

IV. Provider business mailing address

1273 46TH ST BROOKLYN STE 106
BROOKLYN NY
11219-2027
US

V. Phone/Fax

Practice location:
  • Phone: 718-500-3299
  • Fax: 718-500-3299
Mailing address:
  • Phone: 718-500-3299
  • Fax: 718-500-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID VOGEL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 929-275-1579