Healthcare Provider Details

I. General information

NPI: 1609192251
Provider Name (Legal Business Name): ABOVE AND BEYOND LEARNING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 BRAEN AVE SUITE D
WYCKOFF NJ
07481-2948
US

IV. Provider business mailing address

230 BRAEN AVE SUITE D
WYCKOFF NJ
07481-2948
US

V. Phone/Fax

Practice location:
  • Phone: 973-423-2254
  • Fax: 201-820-2434
Mailing address:
  • Phone: 973-423-2254
  • Fax: 201-820-2434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. KAREN BAKKER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 973-423-2254