Healthcare Provider Details

I. General information

NPI: 1609559111
Provider Name (Legal Business Name): ALEJANDRA OLIVA KEYES MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEJANDRA R OLIVA MS, CGC

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COOPER PLZ RM 200
CAMDEN NJ
08103-1438
US

IV. Provider business mailing address

3 COOPER PLZ RM 200
CAMDEN NJ
08103-1438
US

V. Phone/Fax

Practice location:
  • Phone: 856-968-7427
  • Fax: 856-541-6213
Mailing address:
  • Phone: 856-968-7427
  • Fax: 856-541-6213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC001128
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number630
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number25MJ00109100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: