Healthcare Provider Details

I. General information

NPI: 1326615329
Provider Name (Legal Business Name): ALEXANDRA ARIEL WHITE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 HUDSON ST STE 303
HOBOKEN NJ
07030-5641
US

IV. Provider business mailing address

660 WHITE PLAINS ROAD ENTA 4TH FLOOR
TARRYTOWN NY
10591-6820
US

V. Phone/Fax

Practice location:
  • Phone: 201-792-1109
  • Fax:
Mailing address:
  • Phone: 914-333-5801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00113400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: