NPIMap

Organization Active NPI

Bridge the Gap ABA

  • Behavior Analyst
  • Patchogue, NY
National Provider Identifier
1831791433
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BRIDGE THE GAP ABA
Practice address
15 Newman St
Patchogue, NY 11772-1118
Phone
(631) 312-0523
NPI assigned
Nov 10, 2020
Last updated
Nov 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Ms. Jeanne Mac Donald, BCBA
Title
General Partnewr
Phone
(631) 312-0523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

15 Newman St
Patchogue, NY 11772-1118

Mailing address

15 Newman St
Patchogue, NY 11772-1118
Phone (631) 312-0523

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1831791433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 NEWMAN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721118",
            "telephone_number": "631-312-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 NEWMAN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721118",
            "telephone_number": "631-312-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE THE GAP ABA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "MAC DONALD",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "GENERAL PARTNEWR",
        "authorized_official_telephone_number": "631-312-0523",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.

Verify at the official NPI Registry.