Terence G Blackwell Jr.

Individual provider Active NPI Behavior Analyst · South River, NJ

NPI 1386973014 · NPPES record last updated Dec 8, 2009

Key facts

NPI
1386973014
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-03-1234 (NJ)
Practice address
277 Main St
1St Floor
South River, NJ 08882-2042
Phone
(732) 254-0300
Fax
(732) 254-3131
NPI assigned
Dec 8, 2009
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Cerg Management Inc. Past Accepting new patients
Cerg Management Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-03-1234 NJ Yes

Addresses

Primary practice location

277 Main St
1St Floor
South River, NJ 08882-2042

Mailing address

28 Addington CT
East Brunswick, NJ 08816-5302
Phone (732) 672-3471

Other names

  • Mr. Terence G Blackwell Jr. Professional name

Other providers in South River, NJ

All providers in South River, NJ · Behavior Analyst in New Jersey

Sources for this page

Verify at the official NPI Registry.