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General NPI Number Information
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NPI Number | 1801402060
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Entity Type | Organization
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Legal Business Name | DISCOVER LICENSED BEHAVIOR ANALYST PLLC
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 1350 55TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-4213
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Country | US
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Telephone | 134-727-1079
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 55TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-4213
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Country | US
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Telephone | 347-271-0792
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DAVID LEBOWITZ
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Credential |
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Telephone | 134-727-1079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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