Healthcare Provider Details

I. General information

NPI: 1811385289
Provider Name (Legal Business Name): NANCY FIKRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PEHLE AVE STE 200
SADDLE BROOK NJ
07663-5835
US

IV. Provider business mailing address

250 PEHLE AVE STE 200
SADDLE BROOK NJ
07663-5835
US

V. Phone/Fax

Practice location:
  • Phone: 310-990-4443
  • Fax:
Mailing address:
  • Phone: 310-990-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: