Organization
ALIDA A. DOMINIANNI, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALIDA A. DERUSSI (OWNER)
(201) 833-8838
Entity
Organization
Contact information
Practice address
901 TEANECK RD, TEANECK, NJ 07666-4511
(201) 833-8838
Mailing address
901 TEANECK RD, TEANECK, NJ 07666-4511
(201) 833-8838
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NJ
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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