MEDICARE: ASSAS ABA THERAPY SERVICES

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1437008513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSAS ABA THERAPY SERVICES

Provider Business Mailing Address
First Line	:	1240 WALTON AVE APT 325
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-8027
Country	:	US
Telephone Number	:	347-543-8959
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 WALTON AVE APT 325
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-8027
Country	:	US
Telephone Number	:	347-543-8959
Fax Number	:

Authorized Official
Title or Position	:	ABA THERAPIST
Name	:	ASSA GUMANEH
Credential	:	MSED
Telephone Number	:	347-543-8959

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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