Healthcare Provider Details

I. General information

NPI: 1144651506
Provider Name (Legal Business Name): SALOME BRANAS GONZALEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 MORSE AVE
EAST ORANGE NJ
07017-2116
US

IV. Provider business mailing address

33 MORSE AVE
EAST ORANGE NJ
07017-2116
US

V. Phone/Fax

Practice location:
  • Phone: 646-979-0498
  • Fax:
Mailing address:
  • Phone: 646-979-0498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number11312904
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: