Healthcare Provider Details

I. General information

NPI: 1699692228
Provider Name (Legal Business Name): SUCCESS STARS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WASHINGTON ST FL 3
JERSEY CITY NJ
07302-3066
US

IV. Provider business mailing address

58 BIRCH ST
LAKEWOOD NJ
08701-4701
US

V. Phone/Fax

Practice location:
  • Phone: 833-653-1800
  • 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: CHANA RIVKA KOLKO
Title or Position: CREDENTIALING
Credential:
Phone: 833-653-1800