Individual
RAIZY IZRAILEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ED, LBA
Contact information
Practice address
164 ARDMORE AVE, STATEN ISLAND, NY 10314-4324
(917) 748-1793
Mailing address
164 ARDMORE AVE, STATEN ISLAND, NY 10314-4324
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
001499
NY
Other
Enumeration date
12/20/2017
Last updated
12/21/2018
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