Provider Demographics
NPI:1619333275
Name:TVERDOV, ALISON H (PSYD, ABPP-CN)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:H
Last Name:TVERDOV
Suffix:
Gender:F
Credentials:PSYD, ABPP-CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 EASTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1750
Mailing Address - Country:US
Mailing Address - Phone:732-705-1441
Mailing Address - Fax:732-317-8994
Practice Address - Street 1:222 EASTON AVE STE D
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1750
Practice Address - Country:US
Practice Address - Phone:732-705-1441
Practice Address - Fax:732-317-8994
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00553500103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist