Provider Demographics
NPI:1679719074
Name:LUZZI, ROBYN CHRISTINE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:CHRISTINE
Last Name:LUZZI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:DEPEOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:61 WHARTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110
Mailing Address - Country:US
Mailing Address - Phone:201-693-8250
Mailing Address - Fax:
Practice Address - Street 1:61 WHARTON AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1340
Practice Address - Country:US
Practice Address - Phone:201-693-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FL1-09-6448103K00000X
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist