MEDICARE: MY TEAM ABA NJ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1306639737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY TEAM ABA NJ LLC

Provider Business Mailing Address
First Line	:	822 MONTGOMERY AVE STE 304
Second Line	:
City	:	NARBERTH
State	:	PA
Zip	:	19072-1947
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 W MAIN ST
Second Line	:
City	:	PENNS GROVE
State	:	NJ
Zip	:	08069-1348
Country	:	US
Telephone Number	:	404-400-7121
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RITA SCHWARTZ
Credential	:
Telephone Number	:	610-952-8628

Provider Enumeration Date	:	05/28/2025
Last Update Date	:	07/18/2025

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