Provider Demographics
NPI:1790899516
Name:BORRELLI, ALFRED A (MA)
Entity Type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:A
Last Name:BORRELLI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 LINWOOD AVE
Mailing Address - Street 2:APT. 17 K
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3086
Mailing Address - Country:US
Mailing Address - Phone:201-947-7353
Mailing Address - Fax:201-947-7353
Practice Address - Street 1:250 PEHLE AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5830
Practice Address - Country:US
Practice Address - Phone:201-947-7353
Practice Address - Fax:201-947-7353
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00054600101YM0800X, 101YA0400X
NY001087101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)