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NPI Code Detail

MEDICARE: ASHLEY GOGERTY

MEDICARE: ASHLEY GOGERTY
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1730897232
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY GOGERTY
Provider Business Mailing Address
First Line : 224 W 35TH ST STE 500
Second Line :
City : NEW YORK
State : NY
Zip : 10001-2538
Country : US
Telephone Number : 833-646-3222
Fax Number :
Provider Business Practice Location Address
First Line : 5202 EASTPARK BLVD STE 100
Second Line :
City : MADISON
State : WI
Zip : 53718-2151
Country : US
Telephone Number : 833-646-3222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2022
Last Update Date : 12/17/2024

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Directions to “ ASHLEY GOGERTY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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