Healthcare Provider Details

I. General information

NPI: 1487168860
Provider Name (Legal Business Name): ANDRES G ZUNIGA BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 SMITH ST APT 13
PERTH AMBOY NJ
08861-4450
US

IV. Provider business mailing address

701 STATE RT 440 STE 16-1094
JERSEY CITY NJ
07304-1069
US

V. Phone/Fax

Practice location:
  • Phone: 862-417-4746
  • Fax:
Mailing address:
  • Phone: 862-417-4746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-57379
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: