Active NPI
Alexandra Diane Boulanger, M.ED., BCBA
- Behavior Analyst
- Essex Fells, NJ
National Provider Identifier
1720595770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 271687
- Practice address
- 3 Welsh Rd
Essex Fells, NJ 07021-1209 - Phone
- (201) 707-1932
- NPI assigned
- Dec 29, 2017
- Last updated
- Dec 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 271687 | NJ | Primary |
Addresses
Primary practice location
3 Welsh Rd
Essex Fells, NJ 07021-1209
Mailing address
3 Welsh Rd
Essex Fells, NJ 07021-1209
Phone (201) 707-1932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 271687 | NJ | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1720595770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 WELSH RD",
"city": "ESSEX FELLS",
"state": "NJ",
"postal_code": "070211209",
"telephone_number": "201-707-1932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 WELSH RD",
"city": "ESSEX FELLS",
"state": "NJ",
"postal_code": "070211209",
"telephone_number": "201-707-1932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULANGER",
"first_name": "ALEXANDRA",
"middle_name": "DIANE",
"credential": "M.ED., BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-29",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "271687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex Fells, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.