| Doctor Name: | MRS. BITA MIR |
| NPI Number: | 1184027047 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CERTIFIED |
| License Number: | 611162051 |
| Business Practice Address: | 28 Markwood Ln East Northport, NY - 117314015 |
| Business Phone Number: | 6313853379 |
| Business Fax Number: | |
| Mailing Address: | 28 Markwood Ln, EAST NORTHPORT |
| State: | NY |
| Postal Code: | 117314015 |
| Phone Number: | 6313853379 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2014 |
| NPI Last Update Date: | 10/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 611162051 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |