Healthcare Provider Details

I. General information

NPI: 1144926205
Provider Name (Legal Business Name): MELANY MUNOZ GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 LIBRARY LN
MAMARONECK NY
10543-3608
US

IV. Provider business mailing address

37 N PERKINS AVE
ELMSFORD NY
10523-3212
US

V. Phone/Fax

Practice location:
  • Phone: 914-670-1155
  • Fax:
Mailing address:
  • Phone: 914-282-5712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: