Provider Demographics
NPI:1619737889
Name:ALFATIHAH, ALAMIR (CASAC-T)
Entity Type:Individual
Prefix:
First Name:ALAMIR
Middle Name:
Last Name:ALFATIHAH
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WHITESBORO ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-3015
Mailing Address - Country:US
Mailing Address - Phone:315-724-5168
Mailing Address - Fax:315-724-6582
Practice Address - Street 1:500 WHITESBORO ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-3015
Practice Address - Country:US
Practice Address - Phone:315-724-5468
Practice Address - Fax:315-724-6582
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)