Healthcare Provider Details

I. General information

NPI: 1124330634
Provider Name (Legal Business Name): ACHIEVE BEYOND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 CENTRAL AVE STE 2
WESTFIELD NJ
07090-2561
US

IV. Provider business mailing address

225 BROADHOLLOW RD STE 402
MELVILLE NY
11747-4899
US

V. Phone/Fax

Practice location:
  • Phone: 732-204-1635
  • Fax:
Mailing address:
  • Phone: 631-385-7780
  • Fax: 718-886-8694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIA S. MATUZA
Title or Position: CEO
Credential: MA, BCBA, LBA
Phone: 718-762-7633