Healthcare Provider Details

I. General information

NPI: 1679964340
Provider Name (Legal Business Name): OLGA MIKHAILOVNA ALEXEEVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 MADISON AVE STE 302
MORRISTOWN NJ
07960-6967
US

IV. Provider business mailing address

333 WESTCHESTER AVE STE E104
WHITE PLAINS NY
10604-2930
US

V. Phone/Fax

Practice location:
  • Phone: 973-695-8033
  • Fax: 973-538-0043
Mailing address:
  • Phone: 973-695-8033
  • Fax: 973-538-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number25MA12425900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number25MA12425900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA12425900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: