Provider Demographics
NPI:1326309618
Name:ADA HANIFI, DENA (BCBA)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:ADA HANIFI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:
Other - Last Name:ABOELELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ABOELELA
Mailing Address - Street 1:321 VILLAGE RD E
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-2001
Mailing Address - Country:US
Mailing Address - Phone:609-727-2080
Mailing Address - Fax:
Practice Address - Street 1:321 VILLAGE RD E
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-2001
Practice Address - Country:US
Practice Address - Phone:609-727-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-03
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY540764111174400000X
NY540765111174400000X
11831384103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1326309618Medicaid