Provider Demographics
NPI:1780235630
Name:HADAS, TZIPORA YETTA (BCBA)
Entity type:Individual
Prefix:
First Name:TZIPORA
Middle Name:YETTA
Last Name:HADAS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:TZIPORA
Other - Middle Name:YETTA
Other - Last Name:COHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:105 SCHUNNEMUNK RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-6256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 SCHUNNEMUNK RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-6256
Practice Address - Country:US
Practice Address - Phone:973-866-6147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001788-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst