Provider Demographics
NPI:1922511583
Name:BAJRA, EMINA (LP)
Entity Type:Individual
Prefix:
First Name:EMINA
Middle Name:
Last Name:BAJRA
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 GUERNSEY ST
Mailing Address - Street 2:#3L
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2840
Mailing Address - Country:US
Mailing Address - Phone:475-355-7816
Mailing Address - Fax:
Practice Address - Street 1:131 GUERNSEY ST APT 3L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2840
Practice Address - Country:US
Practice Address - Phone:475-355-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001185102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst