Healthcare Provider Details

I. General information

NPI: 1083549448
Provider Name (Legal Business Name): LENA KHOURI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W 82ND ST STE P101
NEW YORK NY
10024-5511
US

IV. Provider business mailing address

16341 17TH AVE APT 2
WHITESTONE NY
11357-3349
US

V. Phone/Fax

Practice location:
  • Phone: 646-389-4112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number002177
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: