Provider Demographics
NPI:1366009078
Name:SIMS, ALEXANDRA JEAN
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JEAN
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 E 84TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4445
Mailing Address - Country:US
Mailing Address - Phone:815-739-6178
Mailing Address - Fax:
Practice Address - Street 1:104 W 40TH ST RM 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3770
Practice Address - Country:US
Practice Address - Phone:844-207-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000885237700000X
COHAD.0000342237700000X
NY14000047635237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist