Provider Demographics
NPI:1023814134
Name:BRANDMAN, AVIGAYIL SARIT
Entity type:Individual
Prefix:
First Name:AVIGAYIL
Middle Name:SARIT
Last Name:BRANDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AVIGAYIL
Other - Middle Name:
Other - Last Name:MOSKOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:2925 W NORTH SHORE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4206
Mailing Address - Country:US
Mailing Address - Phone:773-571-3363
Mailing Address - Fax:
Practice Address - Street 1:2925 W NORTH SHORE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4206
Practice Address - Country:US
Practice Address - Phone:773-571-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2538103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst