Basic Information
Provider Information
NPI: 1356000616
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: ALEXANDRA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: PT,DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 51-55 N ROUTE 9W
Address2:  
City: WEST HAVERSTRAW
State: NY
PostalCode: 109931195
CountryCode: US
TelephoneNumber: 8457864000
FaxNumber:  
Practice Location
Address1: 51-55 N ROUTE 9W
Address2:  
City: WEST HAVERSTRAW
State: NY
PostalCode: 109931195
CountryCode: US
TelephoneNumber: 8457864000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/14/2021
LastUpdateDate: 08/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X048127NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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