Provider Demographics
NPI:1942090196
Name:SYED, SIDRA WASAY (BCBA)
Entity type:Individual
Prefix:
First Name:SIDRA
Middle Name:WASAY
Last Name:SYED
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 HARTFORD TPKE UNIT 27
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4584
Mailing Address - Country:US
Mailing Address - Phone:860-913-1101
Mailing Address - Fax:
Practice Address - Street 1:1645 ELLINGTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2764
Practice Address - Country:US
Practice Address - Phone:860-788-5515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst