Healthcare Provider Details

I. General information

NPI: 1609251792
Provider Name (Legal Business Name): SADIA HALIM L.M.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17810 WEXFORD TER
JAMAICA NY
11432-3050
US

IV. Provider business mailing address

17810 WEXFORD TER
JAMAICA NY
11432-3050
US

V. Phone/Fax

Practice location:
  • Phone: 718-658-1123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number095494
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: