Provider Demographics
NPI:1801499652
Name:TU, TAM KHAI (BCBA)
Entity type:Individual
Prefix:
First Name:TAM
Middle Name:KHAI
Last Name:TU
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:227 RIVERSIDE DR APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6810
Mailing Address - Country:US
Mailing Address - Phone:714-657-4739
Mailing Address - Fax:
Practice Address - Street 1:500 N FRANKLIN TPKE STE 203
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1177
Practice Address - Country:US
Practice Address - Phone:732-867-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12475169103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst