Individual
ELIRON SHAMALOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
10101 67TH DR APT 4F, FOREST HILLS, NY 11375-2702
(347) 476-4330
Mailing address
10101 67TH DR APT 4F, FOREST HILLS, NY 11375-2702
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
002507
NY
103K00000X
Behavior Analyst
—
—
174400000X
Specialist
1609961221
NY
Other
Enumeration date
10/03/2016
Last updated
01/29/2023
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