MEDICARE: YITTY KLEIN 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
1	103K00000X	Behavior Analyst	1-24-73875	NY

General Provider Information

NPI Number	:	1851121909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YITTY KLEIN BCBA

Provider Business Mailing Address
First Line	:	1709 45TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-1375
Country	:	US
Telephone Number	:	732-637-3107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1278 42ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1324
Country	:	US
Telephone Number	:	718-304-9977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	08/05/2024

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