MEDICARE: ELEVATE APPLIED BEHAVIOR ANALYSIS 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1801688775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATE APPLIED BEHAVIOR ANALYSIS PLLC

Provider Business Mailing Address
First Line	:	182 WEBSTER AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-1106
Country	:	US
Telephone Number	:	718-853-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	4502 13TH AVE STE 413
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-6625
Country	:	US
Telephone Number	:	718-650-7894
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MORDECHAI LEIFER
Credential	:
Telephone Number	:	718-650-7894

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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