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NPI Code Detail

MEDICARE: NYANDA BOI BANGAY TRYE

MEDICARE: NYANDA BOI BANGAY TRYE
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 Analyst005083NY

General Provider Information

NPI Number : 1255264784
Entity Type Code : Individual
Provider Name (Legal Business Name) : NYANDA BOI BANGAY TRYE
Provider Business Mailing Address
First Line : 11332 204TH ST
Second Line :
City : SAINT ALBANS
State : NY
Zip : 11412-2535
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 350 5TH AVE STE 6115
Second Line :
City : NEW YORK
State : NY
Zip : 10118-6002
Country : US
Telephone Number : 212-235-5043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ NYANDA BOI BANGAY TRYE ” Practice Location

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