Healthcare Provider Details

I. General information

NPI: 1649105107
Provider Name (Legal Business Name): BRIGHTBRIDGE ABA NEW JERSEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 MINEOLA PL
EDISON NJ
08817-2970
US

IV. Provider business mailing address

743 CENTRAL AVE
WOODMERE NY
11598-2614
US

V. Phone/Fax

Practice location:
  • Phone: 877-309-1868
  • Fax:
Mailing address:
  • Phone:
  • 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: LEONARD JEGER
Title or Position: CEO
Credential:
Phone: 336-510-7910