Blue Pony ABA LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE PONY ABA LLC

Practice address

420 Monticello Ave
Norfolk, VA 23510-0007

Phone

(305) 409-8359

NPI assigned

Nov 8, 2022

Organization subpart

No

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

Authorized official

Name

Yehuda Gittleson

Title

Cfo

Phone

(305) 409-8359

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1235847310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 NUGENT DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MONTICELLO AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235100007",
            "telephone_number": "305-409-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE PONY ABA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "GITTLESON",
        "authorized_official_first_name": "YEHUDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-409-8359"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.