| Proud Moments Aba | |
|
1115 Clifton Ave Ste 202 Clifton NJ 07013-3650 | |
| (718) 215-5311 | |
| Not Available |
| Full Name | Proud Moments Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1115 Clifton Ave Ste 202, Clifton, New Jersey |
| Authorized Official Name and Position | Mark A Yost (GENERAL COUNSEL) |
| Authorized Official Contact | 7182155311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proud Moments Aba 77 Water St Ste 1602 New York NY 10005-4432 Ph: (718) 215-5311 | Proud Moments Aba 1115 Clifton Ave Ste 202 Clifton NJ 07013-3650 Ph: (718) 215-5311 |
| NPI Number | 1295148146 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 07/12/2023 |
| Certification Date | 07/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295148146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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