Individual
BENA NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(718) 762-7633
Mailing address
241 AMBOY ST APT 1, BROOKLYN, NY 11212-5061
(347) 552-8835
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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