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NPI Code Detail

MEDICARE: VIBRANT APPLIED BEHAVIOR THERAPY PLLC

MEDICARE: VIBRANT APPLIED BEHAVIOR THERAPY PLLC
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 Analyst

General Provider Information

NPI Number : 1538879416
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIBRANT APPLIED BEHAVIOR THERAPY PLLC
Provider Business Mailing Address
First Line : 46 COOK ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4004
Country : US
Telephone Number : 718-925-2397
Fax Number : 718-925-2398
Provider Business Practice Location Address
First Line : 46 COOK ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11206-4004
Country : US
Telephone Number : 718-925-2397
Fax Number : 718-925-2398
Authorized Official
Title or Position : COO
Name : JOEL POSEN
Credential :
Telephone Number : 718-925-2397
Provider Enumeration Date : 12/01/2022
Last Update Date : 04/25/2024

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