Active NPI
Samuel Igbafe
- Behavior Technician
- Lakewood, NJ
National Provider Identifier
1124632195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-123715
- Practice address
- 685 River Ave
Lakewood, NJ 08701-5288 - Phone
- (888) 400-7342
- Fax
- (732) 534-8629
- NPI assigned
- Sep 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-20-123715 | VA | Primary |
Addresses
Primary practice location
685 River Ave
Lakewood, NJ 08701-5288
Mailing address
4292 Marly Garden LN Apt 404
Fairfax, VA 22033-6409
Phone (804) 300-7923
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-123715 | VA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599436800000",
"number": "1124632195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4292 MARLY GARDEN LN APT 404",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220336409",
"telephone_number": "804-300-7923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "685 RIVER AVE",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015288",
"telephone_number": "888-400-7342",
"fax_number": "732-534-8629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGBAFE",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-07",
"last_updated": "2020-09-07",
"certification_date": "2020-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT-20-123715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.