Organization
MKSA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANN SCANLON BCBA, LBA (EXECUTIVE DIRECTOR)
(516) 731-5588
Entity
Organization
Contact information
Practice address
125 E BETHPAGE RD, SUITE 5, PLAINVIEW, NY 11803-4228
(516) 731-5588
(516) 577-9049
Mailing address
125 E BETHPAGE RD, SUITE 5, PLAINVIEW, NY 11803-4228
(516) 731-5588
(516) 577-9049
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03858055
—
NY
Enumeration date
01/09/2014
Last updated
07/07/2017
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