Provider Demographics
NPI:1649495128
Name:BUCKLEY, ALEXSANDRA NOELLE (MED)
Entity type:Individual
Prefix:MISS
First Name:ALEXSANDRA
Middle Name:NOELLE
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2919
Mailing Address - Country:US
Mailing Address - Phone:908-654-9621
Mailing Address - Fax:732-636-2645
Practice Address - Street 1:1 WOODBRIDGE CENTER 211
Practice Address - Street 2:JEWELRY EXCHANGE BUILDING
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095
Practice Address - Country:US
Practice Address - Phone:732-636-2645
Practice Address - Fax:732-636-1043
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ527231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2355758OtherAETNA PROVIDER NUMBER