Provider Demographics
NPI:1689197931
Name:ROONEY, ALEXIS CARMELLA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:CARMELLA
Last Name:ROONEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ALEXIS
Other - Middle Name:CARMELLA
Other - Last Name:CONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:224 TAYLOR MILLS ROAD
Mailing Address - Street 2:SUITE 105 B
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3281
Mailing Address - Country:US
Mailing Address - Phone:732-462-8412
Mailing Address - Fax:732-414-6789
Practice Address - Street 1:224 TAYLOR MILLS ROAD
Practice Address - Street 2:SUITE 105 B
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3281
Practice Address - Country:US
Practice Address - Phone:732-462-8412
Practice Address - Fax:732-414-6789
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ978231H00000X
NJ237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3223407Medicaid