Provider Demographics
NPI:1689105827
Name:DAYARAM, NADIA
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:DAYARAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 APPLEWOOD ACRES
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2847
Mailing Address - Country:US
Mailing Address - Phone:718-839-4793
Mailing Address - Fax:
Practice Address - Street 1:1204 APPLEWOOD ACRES
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-2847
Practice Address - Country:US
Practice Address - Phone:718-839-4793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health