Provider Demographics
NPI:1225285562
Name:ALEXANDER, RAYMOND ANTHONY (PT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ANTHONY
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 AVENUE L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3322
Mailing Address - Country:US
Mailing Address - Phone:718-909-8369
Mailing Address - Fax:718-763-5306
Practice Address - Street 1:5820 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3322
Practice Address - Country:US
Practice Address - Phone:718-909-8369
Practice Address - Fax:718-763-5306
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist