Provider Demographics
NPI:1013519958
Name:PYDA, ALEXANDRA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:PYDA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2464 AZALEA WAY
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302-8039
Mailing Address - Country:US
Mailing Address - Phone:551-486-8471
Mailing Address - Fax:
Practice Address - Street 1:2464 AZALEA WAY
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302-8039
Practice Address - Country:US
Practice Address - Phone:551-486-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR238523163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory