Provider Demographics
NPI:1326383571
Name:BITONDO, AMY ELIZABETH (MSED, BCBA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:BITONDO
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 RED MILL RD
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1475
Mailing Address - Country:US
Mailing Address - Phone:914-469-8894
Mailing Address - Fax:
Practice Address - Street 1:111 RED MILL RD
Practice Address - Street 2:APARTMENT 2
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-1475
Practice Address - Country:US
Practice Address - Phone:914-469-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2015-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000479103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst