Provider Demographics
NPI:1821824582
Name:SIMKINS, ALEXANDRA MORGAN (MS, RDN, CDN)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:MORGAN
Last Name:SIMKINS
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:MS
Other - First Name:ALI
Other - Middle Name:MORGAN
Other - Last Name:SIMKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RDN, CDN
Mailing Address - Street 1:374 BROOME ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4083
Mailing Address - Country:US
Mailing Address - Phone:215-262-1659
Mailing Address - Fax:
Practice Address - Street 1:374 BROOME ST APT 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4083
Practice Address - Country:US
Practice Address - Phone:215-262-1659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012109133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered