Basic Information
| Provider Information | |||||||||
| NPI: | 1437552585 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOCHEL | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
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| Credential: | DPT, PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHOENER | ||||||||
| OtherFirstName: | ALEXANDRA | ||||||||
| OtherMiddleName: | M | ||||||||
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| OtherCredential: | DPT, PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1 CREDIT UNION WAY | ||||||||
| Address2: | FL. 3 | ||||||||
| City: | RANDOLPH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023684633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819613370 | ||||||||
| FaxNumber: | 7819611291 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 ELMWOOD ST | ||||||||
| Address2: | |||||||||
| City: | N ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027601304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086952280 | ||||||||
| FaxNumber: | 5086952298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2014 | ||||||||
| LastUpdateDate: | 03/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT023988 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 22695 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 110120615A | 05 | MA | MEDICAID | 4172419 | 01 | MA | AETNA | OTHER | 441819 | 01 | MA | TUFTS | OTHER |