Provider Demographics
NPI:1124054242
Name:RHOUDDOU, ALEX E (CRNA, APRN)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:E
Last Name:RHOUDDOU
Suffix:
Gender:M
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CHRISTOPHER CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-4260
Mailing Address - Country:US
Mailing Address - Phone:860-529-8038
Mailing Address - Fax:
Practice Address - Street 1:68 S SERVICE RD
Practice Address - Street 2:SUITE 350
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2354
Practice Address - Country:US
Practice Address - Phone:516-945-3000
Practice Address - Fax:516-945-3131
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003390367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered