Healthcare Provider Details

I. General information

NPI: 1780596072
Provider Name (Legal Business Name): KIAN PATRICK DOWNES LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 RIVER RD STE 32
EDGEWATER NJ
07020-1149
US

IV. Provider business mailing address

25 E 42ND ST
BAYONNE NJ
07002-4848
US

V. Phone/Fax

Practice location:
  • Phone: 201-373-6947
  • Fax:
Mailing address:
  • Phone: 201-726-0233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: