Healthcare Provider Details

I. General information

NPI: 1356263248
Provider Name (Legal Business Name): ALEXANDRA LEIGH SHULMAN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3068 38TH ST
ASTORIA NY
11103-5095
US

IV. Provider business mailing address

348 E 66TH ST APT 32
NEW YORK NY
10065-6833
US

V. Phone/Fax

Practice location:
  • Phone: 929-260-1960
  • Fax:
Mailing address:
  • Phone: 908-310-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number036843
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: