Provider Demographics
NPI:1336802586
Name:CORTICA NEW JERSEY ABA THERAPIES PC
Entity Type:Organization
Organization Name:CORTICA NEW JERSEY ABA THERAPIES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTANGADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-216-8837
Mailing Address - Street 1:6160 CORNERSTONE CT E STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3724
Mailing Address - Country:US
Mailing Address - Phone:858-216-8837
Mailing Address - Fax:888-383-0040
Practice Address - Street 1:67A MOUNTAIN BLVD
Practice Address - Street 2:EXT. 1ST FLOOR, UNIT B
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5626
Practice Address - Country:US
Practice Address - Phone:908-873-6337
Practice Address - Fax:908-332-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Multi-Specialty