Provider Demographics
NPI:1710315791
Name:CONNERS, BRIAN (EDS, BCBA)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:CONNERS
Suffix:
Gender:M
Credentials:EDS, BCBA
Other - Prefix:MR
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:YANKOUSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS, BCBA
Mailing Address - Street 1:122 LINN DR APT A
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-3106
Mailing Address - Country:US
Mailing Address - Phone:973-896-9121
Mailing Address - Fax:844-711-9920
Practice Address - Street 1:101 EISENHOWER PARKWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1054
Practice Address - Country:US
Practice Address - Phone:844-823-7865
Practice Address - Fax:844-711-9920
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-13-13631103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst