Provider Demographics
NPI:1699227132
Name:NAIK, HETAL (BCBA)
Entity type:Individual
Prefix:MISS
First Name:HETAL
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HORIZON RD
Mailing Address - Street 2:APT. 701
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6651
Mailing Address - Country:US
Mailing Address - Phone:973-919-9739
Mailing Address - Fax:
Practice Address - Street 1:5 HORIZON RD
Practice Address - Street 2:APT. 701
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6651
Practice Address - Country:US
Practice Address - Phone:973-919-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-06-2995103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst