Provider Demographics
NPI:1992165831
Name:SKEFFINGTON, EDWARD III (MA, BCBA)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:
Last Name:SKEFFINGTON
Suffix:III
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-1547
Mailing Address - Country:US
Mailing Address - Phone:973-477-0711
Mailing Address - Fax:
Practice Address - Street 1:30 N 10TH ST
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-1547
Practice Address - Country:US
Practice Address - Phone:973-477-0711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-15-18872103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst