Provider Demographics
NPI:1750008116
Name:GADDI, ALEXANDER T JR (FNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:T
Last Name:GADDI
Suffix:JR
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 N FRANKLIN TPKE STE 203
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1385
Mailing Address - Country:US
Mailing Address - Phone:201-327-0500
Mailing Address - Fax:201-327-8612
Practice Address - Street 1:470 N FRANKLIN TPKE STE 203
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1385
Practice Address - Country:US
Practice Address - Phone:201-327-0500
Practice Address - Fax:201-327-8612
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01348300363LF0000X
NJ26NR16435200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse