Active NPI
Madeline Rebecca Meyers
- Behavior Technician
- Holbrook, NY
National Provider Identifier
1770297103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 231741653
- Practice address
- 991 Main St Ste 100
Holbrook, NY 11741-1608 - Phone
- (631) 676-5645
- NPI assigned
- Jan 10, 2023
- Last updated
- Jan 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 231741653 | NY | Primary |
Addresses
Primary practice location
991 Main St Ste 100
Holbrook, NY 11741-1608
Mailing address
2 Mott Dr
Bellport, NY 11713-2418
Phone (631) 428-5912
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 |
|---|---|---|---|
| 231741653 | NY | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1770297103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MOTT DR",
"city": "BELLPORT",
"state": "NY",
"postal_code": "117132418",
"telephone_number": "631-428-5912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "991 MAIN ST STE 100",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117411608",
"telephone_number": "631-676-5645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYERS",
"first_name": "MADELINE",
"middle_name": "REBECCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-10",
"last_updated": "2023-01-10",
"certification_date": "2023-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NY",
"license": "231741653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.