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NPI Code Detail

MEDICARE: ELLIOT MUSTO RECCHIA

MEDICARE: ELLIOT MUSTO RECCHIA
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 Analyst1-18-29299

General Provider Information

NPI Number : 1164902821
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIOT MUSTO RECCHIA
Provider Business Mailing Address
First Line : 30 BUXTON FARM RD STE 105
Second Line :
City : STAMFORD
State : CT
Zip : 06905-1210
Country : US
Telephone Number :
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 : 08/21/2018
Last Update Date : 08/21/2018

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Directions to “ ELLIOT MUSTO RECCHIA ” Practice Location

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