Provider Demographics
NPI:1700612538
Name:CID, CRISNEILY
Entity type:Individual
Prefix:
First Name:CRISNEILY
Middle Name:
Last Name:CID
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 1:611 PALMER RD APT 4W
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5152
Mailing Address - Country:US
Mailing Address - Phone:646-287-9828
Mailing Address - Fax:
Practice Address - Street 1:611 PALMER RD APT 4W
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5152
Practice Address - Country:US
Practice Address - Phone:646-287-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst