Provider Demographics
NPI:1518320472
Name:ZAGADO, ALEXA-RAE
Entity Type:Individual
Prefix:MS
First Name:ALEXA-RAE
Middle Name:
Last Name:ZAGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5003
Mailing Address - Country:US
Mailing Address - Phone:914-719-2212
Mailing Address - Fax:
Practice Address - Street 1:107 ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5003
Practice Address - Country:US
Practice Address - Phone:914-719-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst