Provider Demographics
NPI:1902515661
Name:RK LICENSED BEHAVIOR ANALYST P.C.
Entity Type:Organization
Organization Name:RK LICENSED BEHAVIOR ANALYST P.C.
Other - Org Name:LADDER ABA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MR
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-370-4000
Mailing Address - Street 1:3611 14TH AVE STE 209B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3773
Mailing Address - Country:US
Mailing Address - Phone:347-541-5240
Mailing Address - Fax:
Practice Address - Street 1:3611 14TH AVE STE 209B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3773
Practice Address - Country:US
Practice Address - Phone:347-541-5240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty