Provider Demographics
NPI:1659101657
Name:RADZISZEWSKI, JANIS
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:
Last Name:RADZISZEWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANIS
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:48 S FRANKLIN TPKE STE 101
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2558
Mailing Address - Country:US
Mailing Address - Phone:201-786-6280
Mailing Address - Fax:
Practice Address - Street 1:48 S FRANKLIN TPKE STE 101
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2558
Practice Address - Country:US
Practice Address - Phone:201-786-6280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst