Individual
DR. ALEXA MARY POLVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
800 POLY PL, PSYCHOLOGY DEPARTMENT, 16TH FLOOR (116B), BROOKLYN, NY 11209-7104
(718) 836-6600
Mailing address
9921 4TH AVE, UNIT 4A, BROOKLYN, NY 11209-8351
(917) 613-2118
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
019528
NY
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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