=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447142989
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REACHING HIGHER LICENSED BEHAVIOR ANALYST PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2025
-----------------------------------------------------
Last Update Date | 07/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 CLERMONT PL
-----------------------------------------------------
City | STATEN ISLAND
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10314-5102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-770-4382
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 CLERMONT PL
-----------------------------------------------------
City | STATEN ISLAND
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10314-5102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-770-4382
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROPRIETOR
-----------------------------------------------------
Name | DR. YITZCHOK KRAKAUER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-770-4382
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------