Healthcare Provider Details

I. General information

NPI: 1366357204
Provider Name (Legal Business Name): DEVIN JOHN CARRAMUSA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 61ST ST STE 301
BROOKLYN NY
11204-2746
US

IV. Provider business mailing address

4 HEGNER CT
SOUTH HACKENSACK NJ
07606-1701
US

V. Phone/Fax

Practice location:
  • Phone: 888-954-0818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-529551
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: