Healthcare Provider Details

I. General information

NPI: 1144168345
Provider Name (Legal Business Name): ALIGN COLLABORATIVE NP IN PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SYLVIA RD
PLAINVIEW NY
11803-6424
US

IV. Provider business mailing address

3 SYLVIA RD
PLAINVIEW NY
11803-6424
US

V. Phone/Fax

Practice location:
  • Phone: 516-644-0120
  • Fax:
Mailing address:
  • Phone: 516-644-0120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AJAY RAJENDRA BALLADIN
Title or Position: PRESIDENT
Credential: NP
Phone: 516-644-0120