Provider Demographics
NPI:1588151351
Name:PITHAVA, NISTHA (ABA THERAPIST)
Entity type:Individual
Prefix:MISS
First Name:NISTHA
Middle Name:
Last Name:PITHAVA
Suffix:
Gender:F
Credentials:ABA THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 BERKLEY ST APT A
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-5370
Mailing Address - Country:US
Mailing Address - Phone:551-427-3509
Mailing Address - Fax:
Practice Address - Street 1:874 BERKLEY ST APT A
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-5370
Practice Address - Country:US
Practice Address - Phone:551-427-3509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst