NPI 1558166355 · live from the CMS NPI Registry
David Abdurachmanov
Behavior Analyst in Lakewood, NJ. National Provider Identifier 1558166355, active.
NPI record
| NPI | 1558166355 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 126 Melville Ave, Lakewood, NJ 08701 |
| Practice phone | 732-886-8113 |
| Mailing address | 644 Weston Dr, Toms River, NJ 08755 |
| Enumerated | February 17, 2025 |
| Last updated | February 17, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 12579260 (NJ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.