Healthcare Provider Details

I. General information

NPI: 1992635387
Provider Name (Legal Business Name): BLUE ABA CONNECTICUT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 RIVER RD
WILTON CT
06897-4065
US

IV. Provider business mailing address

15 RIVER RD
WILTON CT
06897-4065
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-1587
  • Fax:
Mailing address:
  • Phone: 786-521-1587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. GERSHON FINK
Title or Position: CEO/MANAGER
Credential: DO
Phone: 786-521-1587