Active NPI
Abby Puchaev
- Behavior Technician
- Baltimore, MD
National Provider Identifier
1609609593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- P-210-029-009-863
- Practice address
- 6216 Lincoln Ave
Baltimore, MD 21209-3325 - Phone
- (901) 530-4499
- NPI assigned
- Aug 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Technician | 106S00000X | P-210-029-009-863 | MD | Primary |
Addresses
Primary practice location
6216 Lincoln Ave
Baltimore, MD 21209-3325
Mailing address
6216 Lincoln Ave
Baltimore, MD 21209-3325
Phone (901) 530-4499
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
| License | State | Type | Specialty |
|---|---|---|---|
| P-210-029-009-863 | MD | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1609609593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6216 LINCOLN AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093325",
"telephone_number": "901-530-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6216 LINCOLN AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093325",
"telephone_number": "901-530-4499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUCHAEV",
"first_name": "ABBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-26",
"last_updated": "2024-08-26",
"certification_date": "2024-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MD",
"license": "P-210-029-009-863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.