Provider Demographics
NPI:1073272571
Name:GORDA, ALEXA RAY (DPM)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAY
Last Name:GORDA
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:RAY
Other - Last Name:SANTOMERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:951 ROUTE 73 N STE B
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1279
Mailing Address - Country:US
Mailing Address - Phone:856-403-7923
Mailing Address - Fax:856-401-3100
Practice Address - Street 1:951 ROUTE 73 N STE B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1279
Practice Address - Country:US
Practice Address - Phone:856-403-7923
Practice Address - Fax:856-401-3100
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-12
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC007234213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery