Provider Demographics
NPI:1467082149
Name:NEGREIRA, ALYSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALYSON
Middle Name:
Last Name:NEGREIRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4006
Mailing Address - Country:US
Mailing Address - Phone:617-908-6958
Mailing Address - Fax:
Practice Address - Street 1:51 W 51 ST
Practice Address - Street 2:SUITE 340
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1951
Practice Address - Country:US
Practice Address - Phone:212-326-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3907103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical