Provider Demographics
NPI:1588405427
Name:HAMADA, NIVIN
Entity type:Individual
Prefix:
First Name:NIVIN
Middle Name:
Last Name:HAMADA
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 1:14148 84TH DR APT 5B
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2450
Mailing Address - Country:US
Mailing Address - Phone:347-756-9663
Mailing Address - Fax:
Practice Address - Street 1:1216 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4483
Practice Address - Country:US
Practice Address - Phone:646-688-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLP3899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health