Healthcare Provider Details

I. General information

NPI: 1124584362
Provider Name (Legal Business Name): BRIGHT BEGINNINGS LICENSED BEHAVIOR ANALYST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 DOGWOOD AVE STE 197
FRANKLIN SQUARE NY
11010-3247
US

IV. Provider business mailing address

672 DOGWOOD AVE STE 197
FRANKLIN SQUARE NY
11010-3247
US

V. Phone/Fax

Practice location:
  • Phone: 516-564-3539
  • 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
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. TZIPI HANINA
Title or Position: LICENSED BEHAVIOR ANALYST
Credential:
Phone: 516-564-3539