Provider Demographics
NPI:1033893649
Name:CONVERY, ANNAMARIA N (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:ANNAMARIA
Middle Name:N
Last Name:CONVERY
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:N
Other - Last Name:CONVERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:84103 BUTTERFLY DR
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-1768
Mailing Address - Country:US
Mailing Address - Phone:551-427-6156
Mailing Address - Fax:
Practice Address - Street 1:1119 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-3669
Practice Address - Country:US
Practice Address - Phone:732-845-6602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-22-62839103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst