MEDICARE: IMAGINABA

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	:	1700756368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGINABA

Provider Business Mailing Address
First Line	:	545 E COUNTY LINE RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1487
Country	:	US
Telephone Number	:	732-732-2058
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 E COUNTY LINE RD
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-1486
Country	:	US
Telephone Number	:	732-732-2058
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHANINA NAKDIMEN
Credential	:	BCBA
Telephone Number	:	848-226-0925

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	02/12/2026

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Directions to “IMAGINABA ” Practice Location

Language	Start Address	Practice Location

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