Provider Demographics
NPI:1336683952
Name:MADDEN, ALIZA (PMHNP-BC, APRN-BC)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MILL VIEW TER
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-3519
Mailing Address - Country:US
Mailing Address - Phone:914-466-4017
Mailing Address - Fax:
Practice Address - Street 1:100B DANBURY RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4110
Practice Address - Country:US
Practice Address - Phone:914-466-4017
Practice Address - Fax:914-358-9781
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY721300163W00000X
NYF402373-1363LP0808X
CT9683363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse