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General NPI Number Information
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NPI Number | 1356254700
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Entity Type | Individual
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Provider Name | THOMAS KEITH
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Gender | Male
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 316 W WESTFIELD AVE
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City | ROSELLE PARK
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State | NJ
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Zip | 07204-1841
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Country | US
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Telephone | 888-966-0746
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Fax |
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Provider Business Mailing Address
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Address Line | 157 WILSON ST
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City | BOONTON
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State | NJ
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Zip | 07005-2234
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Country | US
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Telephone | 201-962-6733
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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 |
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License Number State | NJ
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