Provider Demographics
NPI:1164117354
Name:SCHLEIFER-KATZ, EVAN ZAK (BCBA)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:ZAK
Last Name:SCHLEIFER-KATZ
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E 80TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1042
Mailing Address - Country:US
Mailing Address - Phone:562-431-9293
Mailing Address - Fax:
Practice Address - Street 1:406 E 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1042
Practice Address - Country:US
Practice Address - Phone:562-431-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-23-64223103K00000X
NY11222-0000103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst