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General NPI Number Information
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NPI Number | 1205749249
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Entity Type | Individual
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Provider Name | EITA BREINER
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Gender | Female
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 1990 SWARTHMORE AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4580
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Country | US
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Telephone | 732-661-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 25 GARFIELD ST
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2319
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 15BC00425400
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License Number State | NJ
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