Provider Demographics
NPI:1518629807
Name:ALIBERTI, ALEXA ANNE
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:ANNE
Last Name:ALIBERTI
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 1:59 FOUR CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1217
Mailing Address - Country:US
Mailing Address - Phone:347-628-5561
Mailing Address - Fax:
Practice Address - Street 1:310 RICHMOND HILL RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-7509
Practice Address - Country:US
Practice Address - Phone:718-727-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker