MEDICARE: ALEX HYDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1114651213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX HYDE

Provider Business Mailing Address
First Line	:	1521 LOCUST ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3727
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1521 LOCUST ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-3727
Country	:	US
Telephone Number	:	856-425-2406
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2022
Last Update Date	:	01/21/2026

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Directions to “ ALEX HYDE ” Practice Location

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