Provider Demographics
NPI:1962068262
Name:BERENATO, DENNIS MICHAEL JR (BCBA)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:BERENATO
Suffix:JR
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:111 JAMESTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2114
Mailing Address - Country:US
Mailing Address - Phone:609-839-6788
Mailing Address - Fax:
Practice Address - Street 1:1902 FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2007
Practice Address - Country:US
Practice Address - Phone:856-827-7630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst