Provider Demographics
NPI:1831561653
Name:INGBER, ALIZA (MS)
Entity type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:INGBER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 HILLCREST PL
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3127
Mailing Address - Country:US
Mailing Address - Phone:323-371-4176
Mailing Address - Fax:
Practice Address - Street 1:745 HILLCREST PL
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3127
Practice Address - Country:US
Practice Address - Phone:323-371-4176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist