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NPI Code Detail

MEDICARE: MRS. MARLODY DE JESUS NODA BCBA

MEDICARE: MRS. MARLODY DE JESUS NODA BCBA
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
1103K00000XBehavior Analyst15BC00067800NJ

General Provider Information

NPI Number : 1376029736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARLODY DE JESUS NODA BCBA
Provider Business Mailing Address
First Line : 175 BELGROVE DR
Second Line :
City : KEARNY
State : NJ
Zip : 07032-1507
Country : US
Telephone Number : 201-979-1336
Fax Number : 908-940-0338
Provider Business Practice Location Address
First Line : 178 W VETERANS HWY
Second Line :
City : JACKSON
State : NJ
Zip : 08527-3410
Country : US
Telephone Number : 201-979-1336
Fax Number : 908-940-0338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2018
Last Update Date : 03/13/2026

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