1720801608 NPI number — CORNERSTONE ABA CONSULTING, LLC

Table of content: VERONICA JEAN DZIEDZIC BA (NPI 1326769407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720801608 NPI number — CORNERSTONE ABA CONSULTING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNERSTONE ABA CONSULTING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720801608
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1385 HWY 35 # 118
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07748-2012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-947-7541
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
92 KENTUCKY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH MIDDLETOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07748-5346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-947-7541
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAROCCA
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
732-947-7541

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)