Provider Demographics
NPI:1619527892
Name:BACKER, FELIX F (MENTAL HEALTH)
Entity Type:Individual
Prefix:MR
First Name:FELIX
Middle Name:F
Last Name:BACKER
Suffix:
Gender:M
Credentials:MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CHYAM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1401
Mailing Address - Country:US
Mailing Address - Phone:516-526-8215
Mailing Address - Fax:
Practice Address - Street 1:19 CHYAM ST
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1401
Practice Address - Country:US
Practice Address - Phone:516-526-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP102291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health