Provider Demographics
NPI:1073093597
Name:ALEXANDER, RAOUL (RRT)
Entity Type:Individual
Prefix:
First Name:RAOUL
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5913 DOGWOOD MNR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-1945
Mailing Address - Country:US
Mailing Address - Phone:716-563-3967
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE BLVD S
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6862
Practice Address - Country:US
Practice Address - Phone:914-294-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007980227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered