Healthcare Provider Details

I. General information

NPI: 1225941446
Provider Name (Legal Business Name): NYLE DEAN JOSEPH BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 SUNRISE HWY STE 106
MASSAPEQUA NY
11758-5352
US

IV. Provider business mailing address

100 WILSON PL
FREEPORT NY
11520-2630
US

V. Phone/Fax

Practice location:
  • Phone: 516-640-0798
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number005238
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: