Provider Demographics
NPI:1366938805
Name:GARTNER, ALEXANDRA NICOLE (AUD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:NICOLE
Last Name:GARTNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 ROUTE 146 STE 200
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3667
Mailing Address - Country:US
Mailing Address - Phone:518-383-4273
Mailing Address - Fax:518-383-4274
Practice Address - Street 1:950 ROUTE 146 STE 200
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3667
Practice Address - Country:US
Practice Address - Phone:518-383-4273
Practice Address - Fax:518-383-4274
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002835-01231H00000X
NY14000056375237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter