Individual provider Active NPI

David Joseph Fazenbaker

  • Behavior Technician
  • Bridgeton, NJ
National Provider Identifier
1770430530
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-26-520288 Issued in NJ
Practice address
10 Magnolia Ave BLDG a
Bridgeton, NJ 08302-1760
Phone
(718) 215-5311
Fax
(718) 865-5165
NPI assigned
Mar 11, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-26-520288 NJ Primary

Addresses

Primary practice location

10 Magnolia Ave BLDG a
Bridgeton, NJ 08302-1760

Mailing address

PO Box 360595, Pittsburgh PA 15251
Pittsburgh, PA 15251-0001
Phone (718) 215-5311

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

LicenseStateTypeSpecialty
RBT-26-520288NJMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1770430530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360595, PITTSBURGH PA 15251",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152510001",
            "telephone_number": "718-215-5311",
            "fax_number": "718-865-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAGNOLIA AVE BLDG A",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083021760",
            "telephone_number": "718-215-5311",
            "fax_number": "718-865-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZENBAKER",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NJ",
            "license": "RBT-26-520288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.