Healthcare Provider Details

I. General information

NPI: 1346502986
Provider Name (Legal Business Name): VICTORIA CUCCI SCHULTZ BCBA, LBA, MSED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 79TH ST
BROOKLYN NY
11209-3709
US

IV. Provider business mailing address

585 79TH ST FIRST FLOOR
BROOKLYN NY
11209-3709
US

V. Phone/Fax

Practice location:
  • Phone: 917-216-9747
  • Fax:
Mailing address:
  • Phone: 917-216-9747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number001198-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: