Most Relevant Information
Provider Data
| NPI Number: | 1003396649 |
| Provider Name: | JERRICK PETERS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/14/2018 |
| Last Updated: | 08/14/2018 |
Provider Practice Location
500 BI COUNTY BLVD STE 450
FARMINGDALE
NY
117353995
Practice Location Phone/Fax
| Phone: | 7182641640 |
| Fax: |
Provider Mailing Location
500 BI COUNTY BLVD STE 450
FARMINGDALE
NY
117353995
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |