Healthcare Provider Details
I. General information
NPI: 1972440824
Provider Name (Legal Business Name): PLAYFUL ABA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1644 58TH ST
BROOKLYN NY
11204-2118
US
IV. Provider business mailing address
23 HOLDEN SQ
LAKEWOOD NJ
08701-5828
US
V. Phone/Fax
- Phone: 347-522-6032
- Fax:
- Phone: 347-522-6032
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MALKA
BIRNBAUM
Title or Position: BCBA/MANAGER
Credential: MS ED BCBA LBA
Phone: 347-522-6032