Joshua Axelrod, BCBA

Individual provider Active NPI Behavior Analyst · Glen Head, NY

NPI 1366911547 · NPPES record last updated Nov 17, 2018

Key facts

NPI
1366911547
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-16-23562
Practice address
11 Sheppard St
Glen Head, NY 11545-1815
Phone
(516) 768-2727
NPI assigned
Nov 17, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Networks

  • Healthfirst Medicare Network H9678

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-16-23562 Yes

Addresses

Primary practice location

11 Sheppard St
Glen Head, NY 11545-1815

Mailing address

11 Sheppard St
Glen Head, NY 11545-1815

Other providers in Glen Head, NY

All providers in Glen Head, NY · Behavior Analyst in New York

Sources for this page

Verify at the official NPI Registry.