Provider Demographics
NPI:1639991854
Name:GRINBAUM, AHRON (BCBA, LBA-NY)
Entity type:Individual
Prefix:
First Name:AHRON
Middle Name:
Last Name:GRINBAUM
Suffix:
Gender:M
Credentials:BCBA, LBA-NY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MAPLE LEAF RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3031
Mailing Address - Country:US
Mailing Address - Phone:347-343-0131
Mailing Address - Fax:
Practice Address - Street 1:3 ASHER DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-2786
Practice Address - Country:US
Practice Address - Phone:347-343-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003851-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst