MEDICARE: GR BEHAVIOR ANALYSIS

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	:	1740112176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GR BEHAVIOR ANALYSIS

Provider Business Mailing Address
First Line	:	1224 58TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4527
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1224 58TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4527
Country	:	US
Telephone Number	:	917-334-5851
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	GITTY ROSENFELD
Credential	:
Telephone Number	:	917-334-5851

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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