Provider Demographics
NPI:1164056248
Name:DOW, NAIMIBIA
Entity Type:Individual
Prefix:
First Name:NAIMIBIA
Middle Name:
Last Name:DOW
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 1:13919 225TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2742
Mailing Address - Country:US
Mailing Address - Phone:516-859-6795
Mailing Address - Fax:
Practice Address - Street 1:21410 24TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2219
Practice Address - Country:US
Practice Address - Phone:347-321-4091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst