Provider Demographics
NPI:1235492406
Name:BARRERA, ALEXA
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:
Other - Last Name:OVIEDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS ED
Mailing Address - Street 1:255 DEWEY PL
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 DEWEY PL
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3414
Practice Address - Country:US
Practice Address - Phone:201-907-0165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist