Healthcare Provider Details

I. General information

NPI: 1528999513
Provider Name (Legal Business Name): ALEXA MARIE PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 EISENHOWER DR
PARAMUS NJ
07652-1404
US

IV. Provider business mailing address

161 WALNUT ST
BLOOMFIELD NJ
07003-5031
US

V. Phone/Fax

Practice location:
  • Phone: 201-605-9600
  • Fax:
Mailing address:
  • Phone: 973-934-3205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberP26780197451962
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: