Provider Demographics
NPI:1609756089
Name:ALIZA ROTH APPLIED BEHAVIOR ANALYSIS PLLC
Entity type:Organization
Organization Name:ALIZA ROTH APPLIED BEHAVIOR ANALYSIS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALIZA
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:516-754-1625
Mailing Address - Street 1:926 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1606
Mailing Address - Country:US
Mailing Address - Phone:516-754-1625
Mailing Address - Fax:
Practice Address - Street 1:926 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1606
Practice Address - Country:US
Practice Address - Phone:516-754-1625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty