Provider Demographics
NPI:1538810874
Name:ELSHISHINY, SARAH (BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ELSHISHINY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1166
Mailing Address - Country:US
Mailing Address - Phone:908-376-6278
Mailing Address - Fax:
Practice Address - Street 1:23 MULBERRY LN
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1166
Practice Address - Country:US
Practice Address - Phone:908-376-6278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-21-57282103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst