Healthcare Provider Details
I. General information
NPI: 1891282919
Provider Name (Legal Business Name): CHRISTOPHER J TALLMADGE M.A., BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2018
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 CORNWALL RD STE 150
MONMOUTH JUNCTION NJ
08852-2410
US
IV. Provider business mailing address
542 AMHERST ST STE B
NASHUA NH
03063-1016
US
V. Phone/Fax
- Phone: 561-202-3338
- Fax:
- Phone: 561-202-3338
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 15BC00043900 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 01-18-29675 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: