Basic Information
| Provider Information | |||||||||
| NPI: | 1689020323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODOLITZ | ||||||||
| FirstName: | ALEXANDER | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 CENTRE ST | ||||||||
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| City: | WOODMERE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115981305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165879086 | ||||||||
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| Practice Location | |||||||||
| Address1: | 551 5TH AVE RM 1923 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101761901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6467765675 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2016 | ||||||||
| LastUpdateDate: | 05/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.