Provider Demographics
NPI:1013647551
Name:WATTS, ALEXA RAE (PA)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAE
Last Name:WATTS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7519 ANTOINETTE CT
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5253
Mailing Address - Country:US
Mailing Address - Phone:518-253-9058
Mailing Address - Fax:
Practice Address - Street 1:3170 CHILI AVE STE T1A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5452
Practice Address - Country:US
Practice Address - Phone:585-571-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant