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NPI Code Detail

MEDICARE: RAY BRATHWAITE

MEDICARE: RAY BRATHWAITE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1891454708
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAY BRATHWAITE
Provider Business Mailing Address
First Line : 424 CENTRAL AVE STE 2
Second Line :
City : WESTFIELD
State : NJ
Zip : 07090-2561
Country : US
Telephone Number : 908-986-7356
Fax Number :
Provider Business Practice Location Address
First Line : 424 CENTRAL AVE STE 2
Second Line :
City : WESTFIELD
State : NJ
Zip : 07090-2561
Country : US
Telephone Number : 732-204-1635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2021
Last Update Date : 12/14/2021

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Directions to “ RAY BRATHWAITE ” Practice Location

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