Healthcare Provider Details

I. General information

NPI: 1851239321
Provider Name (Legal Business Name): GOLD STAR ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 BUCKINGHAM DR
JACKSON NJ
08527-2640
US

IV. Provider business mailing address

80 BUCKINGHAM DR
JACKSON NJ
08527-2640
US

V. Phone/Fax

Practice location:
  • Phone: 347-277-7635
  • Fax:
Mailing address:
  • Phone: 347-277-7635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GITTY MANDEL
Title or Position: OWNER
Credential: BCBA
Phone: 347-277-7635