Provider Demographics
NPI:1679238661
Name:EFTHALIA PIACQUADIO LICENSED BEHAVIOR ANALYST PC
Entity Type:Organization
Organization Name:EFTHALIA PIACQUADIO LICENSED BEHAVIOR ANALYST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APPLIED BEHAVIOR ANALYSIS
Authorized Official - Prefix:
Authorized Official - First Name:EFTHALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIACQUADIO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:516-996-8629
Mailing Address - Street 1:1625 FOXGLOVE RD
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1103
Mailing Address - Country:US
Mailing Address - Phone:516-996-8629
Mailing Address - Fax:516-489-3794
Practice Address - Street 1:1625 FOXGLOVE RD
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-1103
Practice Address - Country:US
Practice Address - Phone:516-996-8629
Practice Address - Fax:516-489-3794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty