Provider Demographics
NPI:1598527657
Name:A AND J BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:A AND J BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABA THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TEQUAN
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:ELEY
Authorized Official - Suffix:
Authorized Official - Credentials:RBT
Authorized Official - Phone:973-391-7632
Mailing Address - Street 1:203 POMONA AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1725
Mailing Address - Country:US
Mailing Address - Phone:973-391-7622
Mailing Address - Fax:
Practice Address - Street 1:203 POMONA AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-1725
Practice Address - Country:US
Practice Address - Phone:973-391-7622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty