Healthcare Provider Details
I. General information
NPI: 1083388862
Provider Name (Legal Business Name): BINAH APPLIED BEHAVIOR ANALYSIS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
282 N MIDDLETOWN RD
PEARL RIVER NY
10965-1216
US
IV. Provider business mailing address
PO BOX 1197
PEARL RIVER NY
10965-0597
US
V. Phone/Fax
- Phone: 833-334-3257
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDDY
JOSEPH
Title or Position: CEO
Credential: BCBA
Phone: 833-334-3257