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Ian James Nutkis

Behavior Analyst

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Ian James Nutkis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1073123998
Provider Type
Individual
Full Name
Nutkis, Ian James
Credential
BCBA

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/5/2020
Last Updated
8/5/2020

Contact Information

Practice Location

329 Aycrigg Ave, Passaic, NJ 07055-3713

(973) 471-3046

Unlisted Fax

Mailing Location

43 Fairfield Ave, West Caldwell, NJ 07006-7603

(973) 919-4503

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103K00000X Primary	Description Behavior Analyst Behavioral Health & Social Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 1-12-10205	Description Other	Issuer BACB New Jersey

Ian James Nutkis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Felder, Aviva

Levine, Naomi

Schmidt, Alexandra

Aba Coterie Nj Llc

Feigenbaum, Galia Elke

Clear View Aba Llc

Silberman, Helen

Schlachter, Laurie

Ratner, Chava

Trusty, Stephanie