Provider Demographics
NPI:1477608941
Name:SMITH, ALEXANDRA GREGG
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:GREGG
Last Name:SMITH
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 1:1650 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7679
Mailing Address - Country:US
Mailing Address - Phone:718-992-7669
Mailing Address - Fax:
Practice Address - Street 1:119 WEST 57TH STREET
Practice Address - Street 2:SUITE 1100
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-757-4488
Practice Address - Fax:212-757-3555
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0763581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical