MEDICARE: UP AND UP ABA 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	:	1487428835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UP AND UP ABA LLC

Provider Business Mailing Address
First Line	:	1 KITAY CT
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-3957
Country	:	US
Telephone Number	:	718-344-8623
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 KITAY CT
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-3957
Country	:	US
Telephone Number	:	718-344-8623
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TUVIA KORN
Credential	:
Telephone Number	:	718-344-8623

Provider Enumeration Date	:	11/07/2023
Last Update Date	:	11/07/2023

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Directions to “UP AND UP ABA LLC ” Practice Location

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