Provider Demographics
NPI:1366324832
Name:COOKE, ALEXANDRA LYNN (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:LYNN
Last Name:COOKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:LYNN
Other - Last Name:KIMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1010 WESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2551
Mailing Address - Country:US
Mailing Address - Phone:315-225-5519
Mailing Address - Fax:
Practice Address - Street 1:8299 TURIN RD
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-1913
Practice Address - Country:US
Practice Address - Phone:315-336-0307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050321-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist