Healthcare Provider Details

I. General information

NPI: 1407788813
Provider Name (Legal Business Name): CONNOR FARLEY BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 ATRIUM WAY STE 430
MOUNT LAUREL NJ
08054-3914
US

IV. Provider business mailing address

20 WESTERVELT PLACE 2F
JERSEY CITY NJ
07304
US

V. Phone/Fax

Practice location:
  • Phone: 856-412-8840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB688964
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: