Provider Demographics
NPI:1194389882
Name:GELDWERTH, CHAYA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CHAYA
Middle Name:
Last Name:GELDWERTH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MARTHA RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1406
Mailing Address - Country:US
Mailing Address - Phone:845-357-3055
Mailing Address - Fax:
Practice Address - Street 1:6 MARTHA RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1406
Practice Address - Country:US
Practice Address - Phone:845-357-3055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-28
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-19-35776103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst