Provider Demographics
NPI:1770001711
Name:KRISHNASWAMY, JAYSHREE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:JAYSHREE
Middle Name:
Last Name:KRISHNASWAMY
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PRIMROSE CIR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-9416
Mailing Address - Country:US
Mailing Address - Phone:609-647-8198
Mailing Address - Fax:
Practice Address - Street 1:825 GEORGES ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NORTH BRUSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-227-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst