Provider Demographics
NPI:1386236420
Name:AFF AUTISM CORP
Entity type:Organization
Organization Name:AFF AUTISM CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-991-5956
Mailing Address - Street 1:19201 COLLINS AVE # CU-123
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2202
Mailing Address - Country:US
Mailing Address - Phone:833-233-4273
Mailing Address - Fax:917-677-8601
Practice Address - Street 1:19201 COLLINS AVE # CU-123
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-2202
Practice Address - Country:US
Practice Address - Phone:833-233-4273
Practice Address - Fax:917-677-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-11-9021OtherBCBA
NY000505-1OtherLBA
NY1851596100OtherNPI