Provider Demographics
NPI:1104614213
Name:GLOVER, ALEXANDRIA J
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:J
Last Name:GLOVER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3610
Mailing Address - Country:US
Mailing Address - Phone:914-299-9635
Mailing Address - Fax:
Practice Address - Street 1:34 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3610
Practice Address - Country:US
Practice Address - Phone:914-299-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030140-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist