Healthcare Provider Details

I. General information

NPI: 1871854430
Provider Name (Legal Business Name): CINDY BETH GEVARTER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 HUGUENOT ST FL 4
NEW ROCHELLE NY
10801-5200
US

IV. Provider business mailing address

1 BROAD PKWY APT 6L
WHITE PLAINS NY
10601-3720
US

V. Phone/Fax

Practice location:
  • Phone: 914-251-0905
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number897467
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1119251
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number01134
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: