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General NPI Number Information
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NPI Number | 1932718012
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Entity Type | Individual
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Provider Name | WALEED ELDER BCBA, LBA
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Gender | Male
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Dates
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Enumeration Date | 07/24/2020
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 225 BROADHOLLOW RD
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City | MELVILLE
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State | NY
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Zip | 11747-4822
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Country | US
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Telephone | 631-385-7780
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Fax |
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Provider Business Mailing Address
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Address Line | 1781 W 13TH ST
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City | BROOKLYN
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State | NY
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Zip | 11223-1031
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Country | US
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Telephone | 718-753-2648
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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 | 105004-01
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License Number State | NY
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