Provider Demographics
NPI:1700219573
Name:VISCO, MARIA CATHERINE (BCBA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CATHERINE
Last Name:VISCO
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 1:503 E 78TH ST
Mailing Address - Street 2:APT. 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1175
Mailing Address - Country:US
Mailing Address - Phone:718-869-3545
Mailing Address - Fax:
Practice Address - Street 1:503 E 78TH ST
Practice Address - Street 2:APT. 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1175
Practice Address - Country:US
Practice Address - Phone:718-869-3545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1095848103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst