Healthcare Provider Details

I. General information

NPI: 1053247163
Provider Name (Legal Business Name): DAYANARA TAVERAS BCBA VASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 PINE TREE RD
MONROE NY
10950-3967
US

IV. Provider business mailing address

181 PINE TREE RD
MONROE NY
10950-3967
US

V. Phone/Fax

Practice location:
  • Phone: 646-296-9221
  • Fax:
Mailing address:
  • Phone: 845-662-5014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: