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NPI Code Detail

MEDICARE: CARRIE PARKER MA, BCBA, NY-LBA

MEDICARE: CARRIE PARKER MA, BCBA, NY-LBA
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 Analyst1-13-14040

General Provider Information

NPI Number : 1699406611
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE PARKER MA, BCBA, NY-LBA
Provider Business Mailing Address
First Line : 2 PAULA ST
Second Line :
City : EAST NORTHPORT
State : NY
Zip : 11731-5023
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2312 SECANE RD
Second Line :
City : SECANE
State : PA
Zip : 19018-2810
Country : US
Telephone Number : 267-564-5717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2022
Last Update Date : 06/21/2022

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