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General NPI Number Information
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NPI Number | 1811510134
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Entity Type | Organization
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Legal Business Name | LICENSED APPLIED BEHAVIOR ANALYSIS SERVICES OF NEW YORK P.C.
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 25 DOLPHIN GRN APT G2C
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3163
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Country | US
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Telephone | 347-697-0904
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Fax |
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Provider Business Mailing Address
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Address Line | 25 DOLPHIN GRN APT G2C
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3163
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Country | US
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Telephone | 347-697-0904
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MEGAN MILLER
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Credential | MSED, BCBA, NYS LBA
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Telephone | 347-697-0904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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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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