Provider Demographics
NPI:1083865950
Name:SHAYA, HENRIETTA (MSED)
Entity Type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:
Last Name:SHAYA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-0180
Mailing Address - Country:US
Mailing Address - Phone:718-746-4833
Mailing Address - Fax:
Practice Address - Street 1:37-11 35TH AVE
Practice Address - Street 2:ALL ABOUT KIDS
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11011-3105
Practice Address - Country:US
Practice Address - Phone:718-706-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst