Provider Demographics
NPI:1629541388
Name:BLECHMAN, PETER JAY (EDD, BCBA, LBA)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAY
Last Name:BLECHMAN
Suffix:
Gender:M
Credentials:EDD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 WATCH HILL DR
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1015
Mailing Address - Country:US
Mailing Address - Phone:845-905-9178
Mailing Address - Fax:
Practice Address - Street 1:74 WATCH HILL DR
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1015
Practice Address - Country:US
Practice Address - Phone:845-905-9178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-05
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000294106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst