Healthcare Provider Details

I. General information

NPI: 1427827955
Provider Name (Legal Business Name): TIFFANY MOY-CHEUNG M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 RTE 34
MATAWAN NJ
07747-1947
US

IV. Provider business mailing address

5 CARRINGTON CT
MATAWAN NJ
07747-6844
US

V. Phone/Fax

Practice location:
  • Phone: 802-304-4042
  • Fax:
Mailing address:
  • Phone: 732-861-7516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-48704
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: