Provider Demographics
NPI:1588452411
Name:RIESTER, ALEXIS SOMMER
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SOMMER
Last Name:RIESTER
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 1:1314 GREENBRIER LN
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1917
Mailing Address - Country:US
Mailing Address - Phone:716-345-1070
Mailing Address - Fax:
Practice Address - Street 1:1419 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2936
Practice Address - Country:US
Practice Address - Phone:716-580-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist