Provider Demographics
NPI:1104398700
Name:SOLOVEITCHIK, CHAYA (BCBA)
Entity Type:Individual
Prefix:
First Name:CHAYA
Middle Name:
Last Name:SOLOVEITCHIK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHAYA
Other - Middle Name:
Other - Last Name:KURLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:12 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4332
Mailing Address - Country:US
Mailing Address - Phone:845-263-0800
Mailing Address - Fax:
Practice Address - Street 1:126 MELVILLE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4235
Practice Address - Country:US
Practice Address - Phone:908-910-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-18-31035103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst