1598513988 NPI number — KAIROS APPLIED BEHAVIOR ANALYSIS PLLC

Table of content: (NPI 1598513988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598513988 NPI number — KAIROS APPLIED BEHAVIOR ANALYSIS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAIROS APPLIED BEHAVIOR ANALYSIS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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Provider Other Name Prefix Text:
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NPI Number Information

NPI Number:
1598513988
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 WALL ST FL 8
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10005-2205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-205-2494
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 VAN CORTLANDT AVE W # 2J
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-205-2494
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2024

Additional Information

Authorized Official

Authorized Official Last Name:
MALLOL
Authorized Official First Name:
MARLENI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
347-205-2494

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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