Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | P09386 | NY |
NPI | 1003305608 |
---|---|
Provider Name | Uri Bornstein |
First Address | Brooklyn, NY 11218-4507 |
Second Address | Brooklyn, NY 11218-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2018 |
Last Update Date | 09/05/2018 |