Provider Demographics
NPI:1568843589
Name:DAVIDSON, ALEXANDRA
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:DAVIDSON
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 1:2 STUYVESANT OVAL
Mailing Address - Street 2:APT. 4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2111
Mailing Address - Country:US
Mailing Address - Phone:720-291-8477
Mailing Address - Fax:
Practice Address - Street 1:2 STUYVESANT OVAL
Practice Address - Street 2:APT. 4A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2111
Practice Address - Country:US
Practice Address - Phone:720-291-8477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist