=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821801796
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PETER MURPHY OJUGO MA, BCBA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2025
-----------------------------------------------------
Last Update Date | 01/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 BETHANY RD STE 92
-----------------------------------------------------
City | HAZLET
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07730-1669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-500-3848
-----------------------------------------------------
Fax | 855-500-3848
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 BETHANY RD STE 92
-----------------------------------------------------
City | HAZLET
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07730-1669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-500-3848
-----------------------------------------------------
Fax | 855-500-3848
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-24-78066
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------