Provider Demographics
NPI:1528719218
Name:PITTON, ANYA
Entity type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:PITTON
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 1:140 CADMAN PLZ W APT 14F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1878
Mailing Address - Country:US
Mailing Address - Phone:347-423-2393
Mailing Address - Fax:
Practice Address - Street 1:445 BROADHOLLOW RD STE 25
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3645
Practice Address - Country:US
Practice Address - Phone:917-817-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty