Provider Demographics
NPI:1891350344
Name:MENDELSOHN, ALEXA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:MENDELSOHN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 34TH ST APT 14O
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4611
Mailing Address - Country:US
Mailing Address - Phone:516-313-4496
Mailing Address - Fax:
Practice Address - Street 1:301 SULLIVAN PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-2909
Practice Address - Country:US
Practice Address - Phone:516-313-4496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14147407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist