Provider Demographics
NPI:1639324106
Name:DEVOID, ALEXANDRIA LUCILLE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:LUCILLE
Last Name:DEVOID
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:LUCILLE
Other - Last Name:CASCONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3167
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:973-887-3816
Practice Address - Street 1:1111 CLIFTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3633
Practice Address - Country:US
Practice Address - Phone:973-400-3730
Practice Address - Fax:973-400-3731
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22382225100000X
NJ40QA01258300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ140429V8JMedicare PIN