Healthcare Provider Details

I. General information

NPI: 1861301020
Provider Name (Legal Business Name): BRITTANY A DEROGATIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 OLD NEW BRUNSWICK RD
PISCATAWAY NJ
08854-3734
US

IV. Provider business mailing address

3 MONICA CT
BRANCHBURG NJ
08876-3571
US

V. Phone/Fax

Practice location:
  • Phone: 732-981-1001
  • Fax:
Mailing address:
  • Phone: 908-210-7432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00414200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: