Provider Demographics
NPI:1659012516
Name:CAMINNECI, ALEXANDRA LAUREN
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LAUREN
Last Name:CAMINNECI
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 1:155 WASHINGTON ST APT 1006
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4580
Mailing Address - Country:US
Mailing Address - Phone:201-403-5673
Mailing Address - Fax:
Practice Address - Street 1:538 BAYLOR AVE
Practice Address - Street 2:
Practice Address - City:RIVER VALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-5925
Practice Address - Country:US
Practice Address - Phone:201-403-5673
Practice Address - Fax:201-603-5011
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01130700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist