Healthcare Provider Details

I. General information

NPI: 1205714227
Provider Name (Legal Business Name): ALEXANDRA RUOCCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 CHESTNUT ST
HAWORTH NJ
07641-1906
US

IV. Provider business mailing address

60 CHESTNUT ST
HAWORTH NJ
07641-1906
US

V. Phone/Fax

Practice location:
  • Phone: 201-994-6926
  • Fax:
Mailing address:
  • Phone: 201-994-6926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: