Provider Demographics
NPI:1134474349
Name:MAHER, NADINE (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SAINT MARKS PL
Mailing Address - Street 2:APT. 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-7946
Mailing Address - Country:US
Mailing Address - Phone:917-399-2192
Mailing Address - Fax:
Practice Address - Street 1:39 SAINT MARKS PL
Practice Address - Street 2:APT. 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-7946
Practice Address - Country:US
Practice Address - Phone:917-399-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1084764103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst