Provider Demographics
NPI:1861985616
Name:ALISON TVERDOV PSYD LLC
Entity type:Organization
Organization Name:ALISON TVERDOV PSYD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:HARTWIG
Authorized Official - Last Name:TVERDOV
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-705-1441
Mailing Address - Street 1:222 EASTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1750
Mailing Address - Country:US
Mailing Address - Phone:732-705-1441
Mailing Address - Fax:732-317-8994
Practice Address - Street 1:222 EASTON AVE STE D
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1750
Practice Address - Country:US
Practice Address - Phone:732-705-1441
Practice Address - Fax:732-317-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5535103T00000X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty