Individual
MR. BENYAMIN Z GRANDOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBA
Contact information
Practice address
5 ROYAL AVE, LAKEWOOD, NJ 08701-3068
(914) 522-6152
Mailing address
5 ROYAL AVE, LAKEWOOD, NJ 08701-3068
(914) 522-6152
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
00204701
NY
Other
Enumeration date
06/25/2012
Last updated
09/11/2024
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