Provider Demographics
NPI:1083281281
Name:HOMICILE, NAIKA A
Entity Type:Individual
Prefix:
First Name:NAIKA
Middle Name:A
Last Name:HOMICILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SCOTLAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5968
Mailing Address - Country:US
Mailing Address - Phone:786-288-1004
Mailing Address - Fax:
Practice Address - Street 1:109 SCOTLAND HILL RD
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-5968
Practice Address - Country:US
Practice Address - Phone:786-288-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst