Provider Demographics
NPI:1538777677
Name:ANWAR, FATIMA (MA, BCBA)
Entity type:Individual
Prefix:MS
First Name:FATIMA
Middle Name:
Last Name:ANWAR
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13981 35TH AVE APT 4M
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-3521
Mailing Address - Country:US
Mailing Address - Phone:646-243-8398
Mailing Address - Fax:
Practice Address - Street 1:734 FRANKLIN AVE # 501
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4525
Practice Address - Country:US
Practice Address - Phone:516-605-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst