Provider Demographics
NPI:1205261732
Name:SURRIDGE, ALEXANDRIA M
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:M
Last Name:SURRIDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TOUCHSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10546-1115
Mailing Address - Country:US
Mailing Address - Phone:845-803-0314
Mailing Address - Fax:
Practice Address - Street 1:51 TOUCHSTONE WAY
Practice Address - Street 2:
Practice Address - City:MILLWOOD
Practice Address - State:NY
Practice Address - Zip Code:10546-1115
Practice Address - Country:US
Practice Address - Phone:845-803-0314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist