Provider Demographics
NPI:1881913473
Name:RINN, IRA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:IRA
Middle Name:
Last Name:RINN
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1617
Mailing Address - Country:US
Mailing Address - Phone:201-403-6460
Mailing Address - Fax:201-608-5222
Practice Address - Street 1:395 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1617
Practice Address - Country:US
Practice Address - Phone:201-403-6460
Practice Address - Fax:201-608-5222
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-23
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-09-6535103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst