Healthcare Provider Details

I. General information

NPI: 1225969561
Provider Name (Legal Business Name): RODERICK MANALO BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 NJ-12
FLEMINGTON NJ
08822
US

IV. Provider business mailing address

15-01 BROADWAY STE 30A
FAIR LAWN NJ
07410-6026
US

V. Phone/Fax

Practice location:
  • Phone: 833-426-7222
  • Fax:
Mailing address:
  • Phone: 833-426-7222
  • 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:
Title or Position:
Credential:
Phone: