Provider Demographics
NPI:1700506342
Name:SCHICK, SHIFRA (BCBA)
Entity Type:Individual
Prefix:
First Name:SHIFRA
Middle Name:
Last Name:SCHICK
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 1:203A RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3447
Mailing Address - Country:US
Mailing Address - Phone:646-770-6730
Mailing Address - Fax:
Practice Address - Street 1:1950 RUTGERS UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4537
Practice Address - Country:US
Practice Address - Phone:732-554-2121
Practice Address - Fax:732-554-1112
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-22-60324103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst