Provider Demographics
NPI:1104514025
Name:ALIMOH, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ALIMOH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 CHAPMAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5412
Mailing Address - Country:US
Mailing Address - Phone:302-703-6332
Mailing Address - Fax:
Practice Address - Street 1:262 CHAPMAN RD BLDG SUITE100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5448
Practice Address - Country:US
Practice Address - Phone:302-703-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-00104251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical