Provider Demographics
NPI:1972230241
Name:KAUFMAN, REID (BCBA)
Entity Type:Individual
Prefix:MR
First Name:REID
Middle Name:
Last Name:KAUFMAN
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 1:66 S 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07803-2914
Mailing Address - Country:US
Mailing Address - Phone:973-876-1778
Mailing Address - Fax:
Practice Address - Street 1:176 ROUTE 46
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-4039
Practice Address - Country:US
Practice Address - Phone:973-876-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-17-26786103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1OtherBEHAVIORAL HEALTH