Provider Demographics
NPI:1154829398
Name:BERGER, AARON (BCBA)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:BERGER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CITADEL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1813
Mailing Address - Country:US
Mailing Address - Phone:718-419-9545
Mailing Address - Fax:
Practice Address - Street 1:47 CITADEL DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-1813
Practice Address - Country:US
Practice Address - Phone:718-419-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-17-29115103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst