Provider Demographics
NPI:1891532651
Name:AMARU, TREVOR
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:AMARU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-2952
Mailing Address - Country:US
Mailing Address - Phone:954-314-8270
Mailing Address - Fax:
Practice Address - Street 1:145 HUDSON ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2952
Practice Address - Country:US
Practice Address - Phone:954-314-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst