Basic Information
| Provider Information | |||||||||
| NPI: | 1477608941 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | GREGG | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 145 EAST 84TH STREET | ||||||||
| Address2: | APT 14C | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9173487394 | ||||||||
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| Practice Location | |||||||||
| Address1: | 119 WEST 57TH STREET | ||||||||
| Address2: | SUITE 1100 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127574488 | ||||||||
| FaxNumber: | 2127573555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 0679451 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.