Individual
MR. SHALOM BORUKHOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1508 MALIBU DR, LAKEWOOD, NJ 08701-3913
(347) 325-8111
Mailing address
1508 MALIBU DR, LAKEWOOD, NJ 08701-3913
(347) 325-8111
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12586213
NJ
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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