Provider Demographics
NPI:1508462334
Name:HAMDAN, ADAM (BCBA)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 BERNICE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1562
Mailing Address - Country:US
Mailing Address - Phone:973-508-6117
Mailing Address - Fax:
Practice Address - Street 1:89 BERNICE RD
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1562
Practice Address - Country:US
Practice Address - Phone:973-508-6117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-20-42574103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst