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NPI Code Detail

MEDICARE: FOSSE APPLIED BEHAVIOR ANALYSIS PLLC

MEDICARE: FOSSE APPLIED BEHAVIOR ANALYSIS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1235088246
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOSSE APPLIED BEHAVIOR ANALYSIS PLLC
Provider Business Mailing Address
First Line : 70 PATRICIA PL
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-1850
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 70 PATRICIA PL
Second Line :
City : CLIFTON
State : NJ
Zip : 07012-1850
Country : US
Telephone Number : 555-555-5555
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JONATHAN ROTHENBERG
Credential :
Telephone Number : 555-555-5555
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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