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General NPI Number Information
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NPI Number | 1275341968
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Entity Type | Individual
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Provider Name | NIKITA SATISH BAVISKAR BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 40 CHRISTOPHER WAY STE 103
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City | EATONTOWN
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State | NJ
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Zip | 07724-3346
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Country | US
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Telephone | 732-841-7734
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Fax |
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Provider Business Mailing Address
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Address Line | 28 BRITTANY LN
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City | JACKSON
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State | NJ
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Zip | 08527-4867
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Country | US
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Telephone | 732-841-7734
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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 | 1-24-78349
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License Number State | NJ
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