MEDICARE: MRS. ALEXANDRA ARIEL WHITE AU.D.

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	231H00000X	Audiologist	41YA00113400	NJ

General Provider Information

NPI Number	:	1326615329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEXANDRA ARIEL WHITE AU.D.

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS ROAD
Second Line	:	ENTA 4TH FLOOR
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-6820
Country	:	US
Telephone Number	:	914-333-5801
Fax Number	:

Provider Business Practice Location Address
First Line	:	79 HUDSON ST STE 303
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5641
Country	:	US
Telephone Number	:	201-792-1109
Fax Number	:

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

Provider Enumeration Date	:	06/08/2021
Last Update Date	:	12/07/2023

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