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NPI Code Detail

MEDICARE: ALEXANDRIA GAYLE NUCCIO PH.D.

MEDICARE: ALEXANDRIA GAYLE NUCCIO PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist

General Provider Information

NPI Number : 1609673706
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRIA GAYLE NUCCIO PH.D.
Provider Business Mailing Address
First Line : 422 MILL ST
Second Line :
City : WORCESTER
State : MA
Zip : 01602-2443
Country : US
Telephone Number : 860-729-8416
Fax Number :
Provider Business Practice Location Address
First Line : 403 BELMONT ST
Second Line :
City : WORCESTER
State : MA
Zip : 01604-1019
Country : US
Telephone Number : 508-856-0104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2025
Last Update Date : 02/05/2026

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