MEDICARE: MRS. MANUELA MARIA ROBLES

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	106E00000X	Assistant Behavior Analyst	102013	NY

General Provider Information

NPI Number	:	1093678666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MANUELA MARIA ROBLES

Provider Business Mailing Address
First Line	:	113 SCHENECTADY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-1708
Country	:	US
Telephone Number	:	347-915-1112
Fax Number	:	347-915-1113

Provider Business Practice Location Address
First Line	:	113 SCHENECTADY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11213-1708
Country	:	US
Telephone Number	:	347-915-1112
Fax Number	:	347-915-1113

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

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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