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General NPI Number Information
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NPI Number | 1023592102
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Entity Type | Individual
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Provider Name | RUBAIYA KARIN BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 142 BEACH 120TH ST
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-1955
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Country | US
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Telephone | 917-881-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 7035 BROADWAY APT C7
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6110
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Country | US
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Telephone | 347-238-9900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | P09925
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License Number State | NY
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