Provider Demographics
NPI:1629664198
Name:MONOSOV, NOHUM (BCBA)
Entity Type:Individual
Prefix:
First Name:NOHUM
Middle Name:
Last Name:MONOSOV
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 1:100 KINGSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3274
Mailing Address - Country:US
Mailing Address - Phone:732-749-0733
Mailing Address - Fax:
Practice Address - Street 1:1950 RUTGERS UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4537
Practice Address - Country:US
Practice Address - Phone:732-554-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-46367103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst