Healthcare Provider Details

I. General information

NPI: 1689491037
Provider Name (Legal Business Name): ALEXANDRA LIKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 UNIVERSITY PLAZA DR 502
HACKENSACK NJ
07601
US

IV. Provider business mailing address

542 AMHERST ST STE B
NASHUA NH
03063-1016
US

V. Phone/Fax

Practice location:
  • Phone: 201-643-7578
  • Fax:
Mailing address:
  • Phone: 201-643-7578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88351
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: