Provider Demographics
NPI:1710377536
Name:ALSAIDI, MOSTAFA (BEHAVIORAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:MOSTAFA
Middle Name:
Last Name:ALSAIDI
Suffix:
Gender:M
Credentials:BEHAVIORAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-1626
Mailing Address - Country:US
Mailing Address - Phone:718-808-5249
Mailing Address - Fax:
Practice Address - Street 1:1149 E 53RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-1626
Practice Address - Country:US
Practice Address - Phone:718-808-5249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst