Provider Demographics
NPI:1326411513
Name:MAKHIJA-GRAHAM, NITA J (PHD)
Entity Type:Individual
Prefix:
First Name:NITA
Middle Name:J
Last Name:MAKHIJA-GRAHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7213 WOODMORE CT
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-6247
Mailing Address - Country:US
Mailing Address - Phone:716-628-2006
Mailing Address - Fax:
Practice Address - Street 1:5500 MAIN ST STE 308
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6737
Practice Address - Country:US
Practice Address - Phone:716-634-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022620103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist