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NPI Code Detail

MEDICARE: GENEVIEVE ELOSKOF BCBA

MEDICARE: GENEVIEVE ELOSKOF BCBA
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 Analyst1-16-24450CA

General Provider Information

NPI Number : 1316463177
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENEVIEVE ELOSKOF BCBA
Provider Business Mailing Address
First Line : 10 WATERSIDE PLZ APT 21E
Second Line :
City : NEW YORK
State : NY
Zip : 10010-2605
Country : US
Telephone Number : 714-745-9156
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 : 08/14/2017
Last Update Date : 08/14/2017

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