Provider Demographics
NPI:1285202648
Name:SCHAEFER, ALEXA ANNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:ANNE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 DAVIES AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2517
Mailing Address - Country:US
Mailing Address - Phone:201-803-9926
Mailing Address - Fax:
Practice Address - Street 1:28 FARVIEW TER
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2740
Practice Address - Country:US
Practice Address - Phone:201-880-9810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02009800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist