Healthcare Provider Details

I. General information

NPI: 1902738966
Provider Name (Legal Business Name): MILESTONE BEHAVIOR THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 BRAMHALL AVE
JERSEY CITY NJ
07304-2335
US

IV. Provider business mailing address

831 BEDFORD AVE # 104
BROOKLYN NY
11205-2801
US

V. Phone/Fax

Practice location:
  • Phone: 347-746-7515
  • 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: MIREL MEISELS
Title or Position: OWNER
Credential:
Phone: 347-746-7515