Healthcare Provider Details

I. General information

NPI: 1861339947
Provider Name (Legal Business Name): BRITTANY CELINE DORTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2037 MORRIS AVE
UNION NJ
07083-6013
US

IV. Provider business mailing address

4 NEW ENGLAND DR
LAKE HIAWATHA NJ
07034-2008
US

V. Phone/Fax

Practice location:
  • Phone: 866-449-2104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89073
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: