Provider Demographics
NPI:1841699725
Name:SYED, HUMIRAH
Entity type:Individual
Prefix:
First Name:HUMIRAH
Middle Name:
Last Name:SYED
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 1:5327 JUNCTION BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4617
Mailing Address - Country:US
Mailing Address - Phone:917-660-4789
Mailing Address - Fax:
Practice Address - Street 1:5327 JUNCTION BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4617
Practice Address - Country:US
Practice Address - Phone:917-660-4789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444910102103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool