MEDICARE: STAND OUT CORP.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	103K00000X	Behavior Analyst
2	1041C0700X	Clinical Social Worker
3	106E00000X	Assistant Behavior Analyst
4	106S00000X	Behavior Technician
5	251B00000X	Case Management Agency	NY
6	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1184099525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAND OUT CORP.

Provider Business Mailing Address
First Line	:	1013 SEAWANE DR
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-2605
Country	:	US
Telephone Number	:	917-435-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 SEAWANE DR
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-2605
Country	:	US
Telephone Number	:	516-362-6043
Fax Number	:	516-940-3025

Authorized Official
Title or Position	:	CEO
Name	:	FELIX MESHMAN
Credential	:
Telephone Number	:	516-295-2019

Provider Enumeration Date	:	12/10/2015
Last Update Date	:	08/14/2025

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Directions to “STAND OUT CORP. ” Practice Location

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