Healthcare Provider Details

I. General information

NPI: 1336821578
Provider Name (Legal Business Name): ALEXA LEIGH RITCHIE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12-15 SADDLE RIVER RD
FAIR LAWN NJ
07410-5808
US

IV. Provider business mailing address

106 S 5TH ST
BETHPAGE NY
11714-2508
US

V. Phone/Fax

Practice location:
  • Phone: 201-797-9522
  • Fax:
Mailing address:
  • Phone: 516-413-0890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02348900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: