Basic Information
| Provider Information | |||||||||
| NPI: | 1073867644 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARYA | ||||||||
| FirstName: | NIDHI | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 DEBRA CT | ||||||||
| Address2: | |||||||||
| City: | OLD WESTBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115681312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5163765046 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 250 NEPTUNE AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112356302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187690405 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2012 | ||||||||
| LastUpdateDate: | 11/05/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 0803651 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.