Provider Demographics
NPI:1861634446
Name:SAROKOFF, RANDI A (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:A
Last Name:SAROKOFF
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-2005
Mailing Address - Country:US
Mailing Address - Phone:201-880-4041
Mailing Address - Fax:
Practice Address - Street 1:623 ELM ST
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-2005
Practice Address - Country:US
Practice Address - Phone:201-880-4041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CERT 1000037103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst