Healthcare Provider Details

I. General information

NPI: 1982266219
Provider Name (Legal Business Name): JENNIFER ANN BRINO BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 SECOND AVE
WEST CAPE MAY NJ
08204-1045
US

IV. Provider business mailing address

420 SECOND AVE
WEST CAPE MAY NJ
08204-1045
US

V. Phone/Fax

Practice location:
  • Phone: 609-602-0165
  • Fax:
Mailing address:
  • Phone: 609-602-0165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12157320
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: