Active NPI
Alexandra Walling
- Licensed Practical Nurse
- Medford, NY
National Provider Identifier
1063829117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 303037
- Practice address
- 91 Cedar Lane
Medford, NY 11763 - Phone
- (631) 617-0952
- NPI assigned
- Jul 21, 2014
- Last updated
- Jul 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 303037 | NY | Primary |
Addresses
Primary practice location
91 Cedar Lane
Medford, NY 11763
Mailing address
91 Cedar LN
Medford, NY 11763-1169
Phone (631) 617-0952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303037 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1063829117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 CEDAR LN",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117631169",
"telephone_number": "631-617-0952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 CEDAR LANE",
"city": "MEDFORD",
"state": "NY",
"postal_code": "11763",
"telephone_number": "631-617-0952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLING",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-21",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "303037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.