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NPI Code Detail

MEDICARE: SVETLANA KONONENKO IYER MSED, BCBA

MEDICARE:   SVETLANA KONONENKO IYER  MSED, 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 Analyst
2103K00000XBehavior Analyst1-11-8448

General Provider Information

NPI Number : 1639666431
Entity Type Code : Individual
Provider Name (Legal Business Name) : SVETLANA KONONENKO IYER MSED, BCBA
Provider Business Mailing Address
First Line : 33 WINTERSET DR
Second Line :
City : MORRIS PLAINS
State : NJ
Zip : 07950-1153
Country : US
Telephone Number : 973-765-4774
Fax Number :
Provider Business Practice Location Address
First Line : 51 GLEN RD
Second Line :
City : MOUNTAIN LAKES
State : NJ
Zip : 07046-1152
Country : US
Telephone Number : 973-765-4774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2018
Last Update Date : 04/17/2018

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Directions to “ SVETLANA KONONENKO IYER MSED, BCBA” Practice Location

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