Healthcare Provider Details

I. General information

NPI: 1750741906
Provider Name (Legal Business Name): ALEXANDRA BENNETT GOEDE PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 E ROBINSON RD SUITE 205
WEST AMHERST NY
14228-2041
US

IV. Provider business mailing address

8205 MAIN ST STE 10
WILLIAMSVILLE NY
14221-6054
US

V. Phone/Fax

Practice location:
  • Phone: 716-691-3400
  • Fax:
Mailing address:
  • Phone: 716-539-0789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF382624
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number686064
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: