Russell Johann
Individual provider Active NPI Behavior Analyst · Shoreham, NY
NPI 1659005684 · NPPES record last updated Jul 14, 2022
Key facts
- NPI
- 1659005684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 6 Bradley Dr
Shoreham, NY 11786-2328 - Phone
- (631) 384-3154
- NPI assigned
- Jul 14, 2022
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
6 Bradley Dr
Shoreham, NY 11786-2328
Mailing address
6 Bradley Dr
Shoreham, NY 11786-2328
Phone (631) 384-3154
Other providers in Shoreham, NY
- Ihab Ibrahim
- Sally Michelle Izquierdo
- Jillian O. Jablonski
- Jar Medical Systems, Inc.
- Jeffrey Kraushaar
- Joann Johannessen
- Nimisha P Joshi
- Annmarie Kane
- Peter Andrew Kaufmann
- Caitlin Margaret Kelly
All providers in Shoreham, NY · Behavior Analyst in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.