Healthcare Provider Details

I. General information

NPI: 1154108504
Provider Name (Legal Business Name): ALEXANDRA DJONOVIC LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 MADISON AVE STE 6
MORRISTOWN NJ
07960-7366
US

IV. Provider business mailing address

26 MADISON AVE STE 6
MORRISTOWN NJ
07960-7366
US

V. Phone/Fax

Practice location:
  • Phone: 973-490-4284
  • Fax:
Mailing address:
  • Phone: 917-693-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120217
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06977200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: