Cordell Cunningham

Individual provider Active NPI Behavior Technician · Hollis, NY

NPI 1225979396 · NPPES record last updated Apr 2, 2026

Key facts

NPI
1225979396
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
20417 Hillside Ave Ste 125
Hollis, NY 11423-2213
Phone
(917) 352-3995
NPI assigned
Apr 2, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

20417 Hillside Ave Ste 125
Hollis, NY 11423-2213

Mailing address

3415 Bataan Memorial W
Las Cruces, NM 88012-5012
Phone (505) 392-3482

Other providers in Hollis, NY

All providers in Hollis, NY · Behavior Technician in New York

Sources for this page

Verify at the official NPI Registry.