Active NPI
Fly Wheel Centers MD LLC
- Behavior Analyst
- Baltimore, MD
National Provider Identifier
1689489585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Legal business name
- FLY WHEEL CENTERS MD LLC
- Practice address
- 7121 Park Heights Ave Unit 401
Baltimore, MD 21215-1610 - Phone
- (347) 661-6533
- NPI assigned
- Feb 10, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shraga F Waxman
- Title
- Ceo
- Phone
- (347) 661-6533
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
7121 Park Heights Ave Unit 401
Baltimore, MD 21215-1610
Mailing address
174 White St
Lakewood, NJ 08701-4054
Phone (347) 524-8681
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739145600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1739145600000",
"number": "1689489585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 WHITE ST",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014054",
"telephone_number": "347-524-8681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7121 PARK HEIGHTS AVE UNIT 401",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212151610",
"telephone_number": "347-661-6533"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLY WHEEL CENTERS MD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-02-10",
"last_updated": "2025-02-10",
"certification_date": "2025-02-10",
"status": "A",
"authorized_official_last_name": "WAXMAN",
"authorized_official_first_name": "SHRAGA",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "347-661-6533"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"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 Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.