Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alisa Sidorov

Individual provider Early Intervention Provider Agency · NPI 1629460829

Alisa Sidorov is an Early Intervention Provider Agency in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2015

Practice location Address checks out

21 Palisade St
Staten Island, NY 10305-4711
Phone: (646) 234-6025
Fax: (718) 273-0324
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Early Intervention Provider Agency (primary) Taxonomy 252Y00000X · Licence 1296222 (NY)

Record details

NPI number1629460829
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 24, 2015
Last updated in NPPESFebruary 24, 2015

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