Fundamental Licensed Behavior Analyst PLLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

FUNDAMENTAL LICENSED BEHAVIOR ANALYST PLLC

Practice address

667 Rodrigues LN
Jackson, NJ 08527-4818

Phone

(732) 314-3019

NPI assigned

Mar 16, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yosef Toledano, BCBA

Title

Member

Phone

(917) 831-9691

Specialties & licenses 1

Addresses

Tax ID family

Fundamental Licensed Behavior Analyst LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fundamental Licensed Behavior Analyst LLC

  • Behavior Analyst
  • Jackson, NJ
  • NPI 1265114466
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1386345270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 RODRIGUES LN",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274818",
            "telephone_number": "732-314-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 RODRIGUES LN",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274818",
            "telephone_number": "732-314-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1054 59th St Ste 1R",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112194824",
            "country_code": "US",
            "telephone_number": "917-831-9691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FUNDAMENTAL LICENSED BEHAVIOR ANALYST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "TOLEDANO",
        "authorized_official_first_name": "YOSEF",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-831-9691",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hershel Friedman
• Yisroel Moshe Friedman, PT, DPT
• Shoshana M Fuchs, MS. ED. BCBA
• Functionalot Services LLC
• Fundamental Licensed Behavior Analyst LLC
• Miriam Tygier Furlong, DMD
• Rachelle Futersak, M.S.
• Shalayah Gaines
• Gabrielle Isabel Galano, MSE, BCBA
• Kaitlyn Gallagher

• Behavior Analyst in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.