Healthcare Provider Details

I. General information

NPI: 1538965165
Provider Name (Legal Business Name): ALEXUS PAIGE PLOUCHER BCBA, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 RICHMOND AVE STE 1
STATEN ISLAND NY
10314-3923
US

IV. Provider business mailing address

294 RIDGEWOOD AVE
STATEN ISLAND NY
10312-2437
US

V. Phone/Fax

Practice location:
  • Phone: 718-698-1300
  • Fax:
Mailing address:
  • Phone: 646-915-7640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: