Provider Demographics
NPI:1528492964
Name:PERATIKOS-KIRITSIS, ALEXIA (PSYD)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:PERATIKOS-KIRITSIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FAIRVIEW AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:973-239-0124
Practice Address - Street 1:110 FAIRVIEW AVE STE 2
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1318
Practice Address - Country:US
Practice Address - Phone:973-239-0011
Practice Address - Fax:973-239-0124
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health