Organization
NACHAS ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVRAHAM WEIZER (CEO)
(917) 595-0406
Entity
Organization
Contact information
Practice address
1400 PINE ST, LAKEWOOD, NJ 08701-4963
(917) 595-0406
(848) 346-0039
Mailing address
1400 PINE ST, LAKEWOOD, NJ 08701-4963
(848) 346-0039
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/27/2025
Last updated
10/30/2025
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