Healthcare Provider Details

I. General information

NPI: 1093670507
Provider Name (Legal Business Name): SAMBA ABA NC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CEDARBRIDGE AVE
LAKEWOOD NJ
08701-4234
US

IV. Provider business mailing address

250 CEDARBRIDGE AVE
LAKEWOOD NJ
08701-4234
US

V. Phone/Fax

Practice location:
  • Phone: 404-779-8860
  • 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: SHMUEL ZYTMAN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 917-858-9016