MEDICARE: ABA PATHWAYS

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

General Provider Information

NPI Number	:	1043769466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABA PATHWAYS

Provider Business Mailing Address
First Line	:	15 VAN BUREN DR UNIT 223
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-5834
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 VAN BUREN DR UNIT 223
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-5834
Country	:	US
Telephone Number	:	845-751-9070
Fax Number	:	945-751-9068

Authorized Official
Title or Position	:	DIRECTOR
Name	:	FEIGE WALDMAN
Credential	:
Telephone Number	:	845-751-9070

Provider Enumeration Date	:	09/27/2016
Last Update Date	:	09/27/2016

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