Healthcare Provider Details

I. General information

NPI: 1073392007
Provider Name (Legal Business Name): ANA RUZIC MS, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 STRATFORD PL
HUNTINGTON NY
11743-3692
US

IV. Provider business mailing address

6 STRATFORD PL
HUNTINGTON NY
11743-3692
US

V. Phone/Fax

Practice location:
  • Phone: 631-455-7813
  • Fax:
Mailing address:
  • Phone: 631-455-7813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number003077-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: