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NPI Code Detail

MEDICARE: MELISSA GRACE SUMADCHAT BCBA

MEDICARE: MELISSA GRACE SUMADCHAT BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1023605888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA GRACE SUMADCHAT BCBA
Provider Business Mailing Address
First Line : 5 LITTLE BROOK LN
Second Line :
City : NEW CITY
State : NY
Zip : 10956-3913
Country : US
Telephone Number : 845-499-0664
Fax Number :
Provider Business Practice Location Address
First Line : 30 BUXTON FARM RD STE 105
Second Line :
City : STAMFORD
State : CT
Zip : 06905-1210
Country : US
Telephone Number : 203-674-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2020
Last Update Date : 12/28/2020

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Directions to “ MELISSA GRACE SUMADCHAT BCBA” Practice Location

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