Healthcare Provider Details

I. General information

NPI: 1477209732
Provider Name (Legal Business Name): APPLETREE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUFFY AVE STE 510
HICKSVILLE NY
11801-3636
US

IV. Provider business mailing address

1135 E VETERANS HIGHWAY
JACKSON TOWNSHIP NJ
08527
US

V. Phone/Fax

Practice location:
  • Phone: 917-809-9259
  • Fax: 516-881-5050
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: YOSEF SHUCK
Title or Position: OWNER
Credential:
Phone: 917-809-9259