Provider Demographics
NPI:1033893672
Name:RYDER, ALEXANDRA (RDN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:RYDER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:KARLEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLONIAL BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:22443-3518
Mailing Address - Country:US
Mailing Address - Phone:518-944-3447
Mailing Address - Fax:
Practice Address - Street 1:34 WILDWOOD RD
Practice Address - Street 2:
Practice Address - City:COLONIAL BEACH
Practice Address - State:VA
Practice Address - Zip Code:22443-3518
Practice Address - Country:US
Practice Address - Phone:518-944-3447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0099442255A2300X
MDDX61442255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer