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General NPI Number Information
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NPI Number | 1093266801
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Entity Type | Individual
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Provider Name | FATIMA HAMZA BALA
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Gender | Female
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 85 EXECUTIVE BLVD UPPR LEVEL
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City | ELMSFORD
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State | NY
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Zip | 10523-1326
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Country | US
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Telephone | 914-347-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 128 ALEXANDER AVE FL 1
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City | YONKERS
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State | NY
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Zip | 10704-4228
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Country | US
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Telephone | 914-433-9064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 66PO3958
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 013919
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License Number State | NY
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