Individual
BRANDON COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 PARSONAGE RD STE 318, EDISON, NJ 08837-2429
(732) 204-1635
(732) 204-1636
Mailing address
22 GRANT AVE, NUTLEY, NJ 07110-1905
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NJ
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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