Provider Demographics
NPI:1043039191
Name:RAINBOW APPLIED BEHAVIOR ANALYSIS NY PLLC
Entity type:Organization
Organization Name:RAINBOW APPLIED BEHAVIOR ANALYSIS NY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-720-8600
Mailing Address - Street 1:300 BROADACRES DR STE 175
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3165
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 OLD POMONA RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-1707
Practice Address - Country:US
Practice Address - Phone:201-720-8600
Practice Address - Fax:201-353-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty