MEDICARE: MR. RUVEN HIRSCHLER 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
1	103K00000X	Behavior Analyst	1-24-75680	NY

General Provider Information

NPI Number	:	1043047046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUVEN HIRSCHLER BCBA

Provider Business Mailing Address
First Line	:	64 TRUMAN AVE
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-8907
Country	:	US
Telephone Number	:	845-478-5795
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 TRUMAN AVE # 111
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-8907
Country	:	US
Telephone Number	:	845-274-8393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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