Healthcare Provider Details

I. General information

NPI: 1649133174
Provider Name (Legal Business Name): FADAH HAIMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 KINGSBRIDGE TER
BRONX NY
10463-5900
US

IV. Provider business mailing address

477 HILDA ST
EAST MEADOW NY
11554-4200
US

V. Phone/Fax

Practice location:
  • Phone: 718-884-0700
  • Fax:
Mailing address:
  • Phone: 646-906-6334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: