Provider Demographics
NPI:1255704227
Name:SZELIGA, AMY (BCBA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SZELIGA
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 1:228 BEACH 98TH ST
Mailing Address - Street 2:#3
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2849
Mailing Address - Country:US
Mailing Address - Phone:718-926-9196
Mailing Address - Fax:
Practice Address - Street 1:228 BEACH 98TH ST
Practice Address - Street 2:#3
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2849
Practice Address - Country:US
Practice Address - Phone:718-926-9196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001021-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst