Provider Demographics
NPI:1720416456
Name:TOOF, ALEXANDRA VICTORIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:VICTORIA
Last Name:TOOF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:V
Other - Last Name:HOPPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:617 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1601
Mailing Address - Country:US
Mailing Address - Phone:802-864-6309
Mailing Address - Fax:
Practice Address - Street 1:368 DORSET ST STE 1
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6236
Practice Address - Country:US
Practice Address - Phone:802-864-6309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9107436363A00000X
VT055-0031251363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009849400Medicaid
GA003140591AMedicaid
VT9000780Medicaid
VTY400340660OtherMEDICARE PTAN
VTY400479724OtherMEDICARE PTAN