Provider Demographics
NPI:1780236984
Name:BAKAY, ROSA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:BAKAY
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 1:134 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2147
Mailing Address - Country:US
Mailing Address - Phone:516-375-3046
Mailing Address - Fax:
Practice Address - Street 1:7-11 S BROADWAY STE 317
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3520
Practice Address - Country:US
Practice Address - Phone:914-948-8004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096309-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY096309-1OtherNYS EDUCATION DEPT OFFICE OF THE PROFESSIONS