Provider Demographics
NPI:1295369346
Name:GEISSBUHLER, ALEXANDER CHARLES (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:CHARLES
Last Name:GEISSBUHLER
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRIDGE ST STE 71
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1560
Mailing Address - Country:US
Mailing Address - Phone:914-478-0608
Mailing Address - Fax:
Practice Address - Street 1:1 BRIDGE ST STE 71
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1560
Practice Address - Country:US
Practice Address - Phone:914-478-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0455602251S0007X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports