Healthcare Provider Details

I. General information

NPI: 1053236422
Provider Name (Legal Business Name): PREYA MAJMUNDAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 ETHEL RD STE 205B
EDISON NJ
08817-2839
US

IV. Provider business mailing address

61 DOLORES DR
EDISON NJ
08817-2342
US

V. Phone/Fax

Practice location:
  • Phone: 732-318-6207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberRBT-24-362680
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: