Provider Demographics
NPI:1699441246
Name:IANNARELLI, ALEXANDRA L
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:L
Last Name:IANNARELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 S. SEAMANS NECK RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783
Mailing Address - Country:US
Mailing Address - Phone:516-491-0964
Mailing Address - Fax:
Practice Address - Street 1:A AND J BEHAVIORAL HEALTH
Practice Address - Street 2:2631 MERRICK RD SUITE 302
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:516-590-7575
Practice Address - Fax:516-590-7573
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst