Provider Demographics
NPI:1649997032
Name:CHAIFETZ, BLIMA (BCBA)
Entity type:Individual
Prefix:
First Name:BLIMA
Middle Name:
Last Name:CHAIFETZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2816
Mailing Address - Country:US
Mailing Address - Phone:929-417-1070
Mailing Address - Fax:
Practice Address - Street 1:1500 AVENUE OF THE STATES
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4789
Practice Address - Country:US
Practice Address - Phone:732-961-7413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst