Provider Demographics
NPI:1881147338
Name:BUCCI, ALEXANDRA (SPEECH-LANGUAGE PATH)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:BUCCI
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:FULGENZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH-LANGUAGE PATH
Mailing Address - Street 1:143 CALIFORNIA ROAD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598
Mailing Address - Country:US
Mailing Address - Phone:914-804-7678
Mailing Address - Fax:
Practice Address - Street 1:143 CALIFORNIA ROAD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598
Practice Address - Country:US
Practice Address - Phone:914-804-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist