Healthcare Provider Details

I. General information

NPI: 1134054695
Provider Name (Legal Business Name): ALISIA MALIBORSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 KNOLLCROFT RD
LYONS NJ
07939-5001
US

IV. Provider business mailing address

151 KNOLLCROFT RD
LYONS NJ
07939-5001
US

V. Phone/Fax

Practice location:
  • Phone: 908-647-0180
  • Fax: 908-604-5836
Mailing address:
  • Phone: 908-647-0180
  • Fax: 908-604-5836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07006200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: