Provider Demographics
NPI:1104163401
Name:RANIERI, ALEXANDRA JENSEN (DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JENSEN
Last Name:RANIERI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NEWFIELD AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3745
Mailing Address - Country:US
Mailing Address - Phone:203-504-8421
Mailing Address - Fax:
Practice Address - Street 1:500 NEWFIELD AVE STE 11
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-3745
Practice Address - Country:US
Practice Address - Phone:203-869-1145
Practice Address - Fax:203-869-6998
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10382225100000X
CT63.001317225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant