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General NPI Number Information
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NPI Number | 1285487769
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Entity Type | Individual
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Provider Name | THOMAS GAVOR BCBA
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Gender | Male
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 147 S PARK DR
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2125
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Country | US
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Telephone | 732-809-9331
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Fax |
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Provider Business Mailing Address
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Address Line | 147 S PARK DR
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2125
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Country | US
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Telephone | 732-809-9331
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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 | 1-24-71152
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License Number State | NJ
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