Provider Demographics
NPI:1346765518
Name:FOX, ALEXA NICOLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:NICOLE
Last Name:FOX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 CENTRAL HWY
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2614
Mailing Address - Country:US
Mailing Address - Phone:845-596-0267
Mailing Address - Fax:
Practice Address - Street 1:351 EVELYN ST STE 301
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2901
Practice Address - Country:US
Practice Address - Phone:201-634-1444
Practice Address - Fax:201-634-1555
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00675400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist