Healthcare Provider Details

I. General information

NPI: 1497668610
Provider Name (Legal Business Name): GOLD STANDARD ELITE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 US HIGHWAY 9 STE 4
MANALAPAN NJ
07726-5105
US

IV. Provider business mailing address

349 US HIGHWAY 9 STE 4
MANALAPAN NJ
07726-5105
US

V. Phone/Fax

Practice location:
  • Phone: 732-616-5169
  • Fax:
Mailing address:
  • Phone: 732-616-5169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. ANNA ASTROVA
Title or Position: OWNER
Credential: OTR-L
Phone: 917-418-8228