Provider Demographics
NPI:1225649106
Name:QUARTET BEHAVIORAL SPECTRUM SERVICES
Entity Type:Organization
Organization Name:QUARTET BEHAVIORAL SPECTRUM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKLAVOUNAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-780-0770
Mailing Address - Street 1:1902 149TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3116
Mailing Address - Country:US
Mailing Address - Phone:516-780-0770
Mailing Address - Fax:
Practice Address - Street 1:1408B CLINTONVILLE ST
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1861
Practice Address - Country:US
Practice Address - Phone:516-780-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty