Individual
DAVID JOSEPH FAZENBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 MAGNOLIA AVE BLDG A, BRIDGETON, NJ 08302-1760
(718) 215-5311
(718) 865-5165
Mailing address
PO BOX 360595, PITTSBURGH PA 15251, PITTSBURGH, PA 15251-0001
(718) 215-5311
(718) 865-5165
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-520288
NJ
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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