Provider Demographics
NPI:1093544264
Name:ORICCHIO, ALEXANDER NICHOLAS (MHC-LP)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:NICHOLAS
Last Name:ORICCHIO
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:ALEXANDER
Other - Middle Name:NICHOLAS
Other - Last Name:ORICCHIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHC-LP
Mailing Address - Street 1:162 KENSINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3025
Mailing Address - Country:US
Mailing Address - Phone:718-306-4770
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE RM 1503
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6666
Practice Address - Country:US
Practice Address - Phone:646-598-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP125703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty