Healthcare Provider Details

I. General information

NPI: 1558917773
Provider Name (Legal Business Name): CHANA GELDZAHLER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 AROSA HL
LAKEWOOD NJ
08701-2133
US

IV. Provider business mailing address

63 AROSA HL
LAKEWOOD NJ
08701-2133
US

V. Phone/Fax

Practice location:
  • Phone: 917-923-7913
  • Fax:
Mailing address:
  • Phone: 917-923-7913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number002715-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-36967
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: