Provider Demographics
NPI:1770360083
Name:RAGUSEO, ALEXANDRA (DPT, PT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:RAGUSEO
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SWIMMING RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1725
Mailing Address - Country:US
Mailing Address - Phone:732-451-4578
Mailing Address - Fax:732-530-3561
Practice Address - Street 1:5 SWIMMING RIVER RD
Practice Address - Street 2:
Practice Address - City:LINCROFT
Practice Address - State:NJ
Practice Address - Zip Code:07738-1725
Practice Address - Country:US
Practice Address - Phone:732-451-4578
Practice Address - Fax:732-530-3561
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02210600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist