Individual
ALEX JOHN RUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
77 W MAIN ST, KINGS PARK, NY 11754-1605
(631) 304-3374
Mailing address
77 W MAIN ST, KINGS PARK, NY 11754-1605
(631) 304-3374
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
78-P138140-01
NY
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/11/2025
Last updated
09/11/2025
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