Provider Demographics
NPI:1558917773
Name:GELDZAHLER, CHANA (BCBA)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:GELDZAHLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 AROSA HL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2133
Mailing Address - Country:US
Mailing Address - Phone:917-923-7913
Mailing Address - Fax:
Practice Address - Street 1:63 AROSA HL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2133
Practice Address - Country:US
Practice Address - Phone:917-923-7913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002715-01103K00000X
NJ1-19-36967103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst