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NPI Code Detail

MEDICARE: ESTHER SIMON MSED, BCBA

MEDICARE: ESTHER SIMON MSED, 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 Analyst1-19-38217NJ

General Provider Information

NPI Number : 1821639576
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTHER SIMON MSED, BCBA
Provider Business Mailing Address
First Line : 80 HILLSIDE BLVD
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3798
Country : US
Telephone Number : 732-534-7325
Fax Number : 732-523-0060
Provider Business Practice Location Address
First Line : 80 HILLSIDE BLVD
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-3798
Country : US
Telephone Number : 732-534-7325
Fax Number : 732-523-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2019
Last Update Date : 10/03/2019

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