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General NPI Number Information
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NPI Number | 1659012516
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Entity Type | Individual
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Provider Name | ALEXANDRA LAUREN CAMINNECI
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 538 BAYLOR AVE
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City | RIVER VALE
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State | NJ
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Zip | 07675-5925
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Country | US
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Telephone | 201-403-5673
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Fax | 201-603-5011
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Provider Business Mailing Address
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Address Line | 155 WASHINGTON ST APT 1006
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City | JERSEY CITY
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State | NJ
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Zip | 07302-4580
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Country | US
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Telephone | 201-403-5673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 41YS01130700
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License Number State | NJ
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