Individual provider Active NPI

Nancy Elbastawisy

  • Behavior Analyst
  • Lebanon, PA
National Provider Identifier
1265205306
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH006767 Issued in PA
Practice address
125 Schneider Dr Unit B
Lebanon, PA 17046-4875
Phone
(717) 270-2425
NPI assigned
Oct 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BH006767 PA Primary

Addresses

Primary practice location

125 Schneider Dr Unit B
Lebanon, PA 17046-4875

Mailing address

632 Pondside LN
Lebanon, PA 17042-9479
Phone (646) 510-6076

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BH006767PAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1265205306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 PONDSIDE LN",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170429479",
            "telephone_number": "646-510-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SCHNEIDER DR UNIT B",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170464875",
            "telephone_number": "717-270-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBASTAWISY",
        "first_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH006767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.