Healthcare Provider Details

I. General information

NPI: 1932037421
Provider Name (Legal Business Name): AMANDA MARIE BERMEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 NJ-15 NORTH
LAFAYETTE NJ
07848
US

IV. Provider business mailing address

55 OLD BEAVER RUN RD
LAFAYETTE NJ
07848-2002
US

V. Phone/Fax

Practice location:
  • Phone: 973-862-6377
  • Fax:
Mailing address:
  • Phone: 973-919-3788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-467023
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: