Provider Demographics
NPI:1265691026
Name:CORTESE, ALEXANDRA (AUD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CORTESE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COMMERCE BOULEVARD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390
Mailing Address - Country:US
Mailing Address - Phone:610-345-0977
Mailing Address - Fax:610-345-0986
Practice Address - Street 1:1 COMMERCE BOULEVARD
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390
Practice Address - Country:US
Practice Address - Phone:610-345-0977
Practice Address - Fax:610-345-0986
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006071231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist