Healthcare Provider Details

I. General information

NPI: 1639856560
Provider Name (Legal Business Name): PANE CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 SMULL AVE
WEST CALDWELL NJ
07006-7848
US

IV. Provider business mailing address

175 SMULL AVE
WEST CALDWELL NJ
07006-7848
US

V. Phone/Fax

Practice location:
  • Phone: 908-305-7041
  • Fax:
Mailing address:
  • Phone: 908-305-7041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER MARIE PANE
Title or Position: OWNER/BEHAVIOR ANALYST
Credential: BCBA-D
Phone: 908-305-7041