Healthcare Provider Details
I. General information
NPI: 1477489748
Provider Name (Legal Business Name): EARLY STAR ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 PERRINEVILLE RD STE 2
MONROE NJ
08831-4924
US
IV. Provider business mailing address
1600 PERRINEVILLE RD STE 2
MONROE NJ
08831-4924
US
V. Phone/Fax
- Phone: 848-351-4450
- Fax: 848-351-4455
- Phone: 848-351-4450
- Fax: 848-351-4455
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
BHAMISHA
PATEL
Title or Position: MANAGING MEMBER
Credential:
Phone: 848-351-4455