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General NPI Number Information
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NPI Number | 1730997750
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Entity Type | Organization
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Legal Business Name | STARRISE ABA MD LLC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 33 WHITEHALL ST FL 17
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City | NEW YORK
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State | NY
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Zip | 10004-2164
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Country | US
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Telephone | 212-363-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 33 WHITEHALL ST FL 17
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City | NEW YORK
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State | NY
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Zip | 10004-2164
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Country | US
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Telephone | 212-363-7500
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JOSEPH LEVI
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Credential |
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Telephone | 212-363-7500
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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 |
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License Number State |
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