Raizy Izrailev, MS ED, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

001499 Issued in NY

Practice address

164 Ardmore Ave
Staten Island, NY 10314-4324

Phone

(917) 748-1793

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Raizy Lamm Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545350400000",
    "number": "1104332519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 ARDMORE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 ARDMORE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144324",
            "telephone_number": "917-748-1793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1042 50th St Apt A2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112193335",
            "country_code": "US",
            "telephone_number": "917-748-1793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IZRAILEV",
        "first_name": "RAIZY",
        "credential": "MS ED, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2018-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "001499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAIZY",
            "last_name": "LAMM",
            "prefix": "MRS.",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Liberty Osa Izevbuwa, MSW
• Shadi Izmikna, PA-C
• Shalom Izrailev
• Krystie Marie Izzo, LMHC
• Pauline Izzo, FNP
• J. Lamendola Physical Therapy, P.C.
• J.J.S. Transportation Company, Inc

• Behavior Analyst in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.