Provider Demographics
NPI:1336729441
Name:BARAGI, HAFUSAH
Entity type:Individual
Prefix:
First Name:HAFUSAH
Middle Name:
Last Name:BARAGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:BARAGI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1139 CLAY AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-5229
Mailing Address - Country:US
Mailing Address - Phone:347-523-3517
Mailing Address - Fax:
Practice Address - Street 1:1139 CLAY AVE APT 10
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-5229
Practice Address - Country:US
Practice Address - Phone:347-523-3517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician